Nutritional management of a complicated surgical patient by means of fistuloclysis

Abstract

A fistula is defined as an abnormal communication between two organs, an organ and the skin, or an organ and a wound.¹ Up to 70% of patients with fistulae present with malnutrition.¹ Enteral nutrition (EN) has considerable advantages over parenteral nutrition (PN) support, including improved gut barrier function, a reduction in infectious morbidity and improved immune function.² EN support remains the preferred route of nutrition support in patients with fistulae, unless it causes a significant increase in fistula output, abdominal pain or exacerbates diarrhoea.¹ Fistuloclysis, i.e. enteral feeding via an intestinal fistula, is an effective means of providing nutritional support to these patients and can replace the need for PN support.³