Frequently Asked Questions

The palatability of EEN has improved over the years and new flavour technologies have meant that it can be taken orally, reserving tube feeding for patients unable to meet their requirements orally. Even so, EEN is a difficult concept to adapt to and it may take your patient a few days to adjust. Many patients will have reduced taste sensitivity after a couple of days on the diet which will help with acceptability. The use of Starter Regimens and flexibility with different flavours all aids compliance. Frequently patients become reluctant to stop taking the diet because they come to rely on it and feel so well, persuading them to eat normal foods again can be more of a challenge than keeping them on the diet!

However some healthcare professionals have quite negative perceptions of how supplements taste, even if they have not tasted them for many years.  It is important that only positive messages are given to patients, to ensure motivation and compliance to EEN remains high.

The volume of Elemental 028 Extra Liquid or Alicalm required should be based on an individual’s nutritional requirements. One tin of Alicalm provides 1,800 kcal and is nutritionally complete. Ten x 250ml cartons of Elemental 028 Extra Liquid provide 2,150kcal and are nutritionally complete.

Firstly, your patient should not feel hungry once the volume prescribed is reached. Also, you may find that your patient’s weight has stabilised or increased. If you find that your patient continues to lose weight, you may need to increase the volume given.

During the introductory phase of EEN it is common for patients to lose a little weight before nutritional requirements are met. In undernourished patients care needs to be taken because further weight loss may cause additional complications. It may be necessary to admit a patient with a low BMI or MUST score for monitoring when commencing a liquid diet and to keep them as an inpatient until requirements are fully met.

The side effects experienced with EEN are minimal. There are no reported complications and it is a very safe adjunctive or primary therapy.

For further information on the normal responses to EEN, please refer to the Dietitian’s Guide.

Yes. The starter regimen is based on volume and concentration if the powdered diets are being used. It is important that these parameters are changed independently so that if the feed is not tolerated the precipitating factor can be identified.

The rate at which the concentration and flow rate of the feed are increased will vary from patient to patient depending on their tolerance, previous food intake and presenting symptoms.

The feed should be administered according to recognised guidelines, e.g. PENG (UK)

This group of patients are unlikely to be confined to bed so it is important to have a regimen that will allow the patients to have periods free from the feed. The patient can be encouraged to try a higher flow rate as their confidence increases in order to have longer periods between feeds. It is better to have small frequent breaks rather than one long one though.

Elemental 028 Extra Liquid can also be used for PEG/NGT feeding though concentration cannot be altered. A gradual increase in feed volume per hour is recommended with additional water flushes.

For further information, starter regimens and additional questions, download the Dietitian’s Guide here

 

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