Fred is 89-year-old retired gentleman with grown up sons, currently living independently in his own home in London.
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In May 2016, he had a PEG feeding tube placed due to dysphagia, primary cause unknown. He remains nil by mouth with an undefined diagnosis for the cause of his dysphagia to the current day.
Fred was a very active man at the time of his PEG placement. He was an avid mountain walker, as well as a keen gardener and enjoyed socialising in the pub.
When his feeding tube was placed, Fred weighed 50.3 kg. With a height of 1.72 m, he had a body mass index of 17 kg/m2.
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To help Fred keep active and limit his time on a feeding pump during the day, his dietitian started Fred on a 1.5 kcal/ml fibre feed overnight, with one 125 ml bolus top up using a syringe during the day. This suited him for a short time, but then Fred started complaining of not tolerating the overnight feed well. He reported symptoms such as nausea and occasional vomiting. This led to Fred experiencing a low mood and affected his quality of life.
Over the next few years, Fred’s overnight feed type was changed several times, but he kept eventually reporting symptoms of gastrointestinal intolerance, which may have been linked to having a feed overnight due to his positioning in bed.
In January 2020 Fred’s feeding regimen was changed to stop overnight feeding all together, and to instead meet his nutritional requirements through bolus feeds during the day. He started off on 5 feeds a day which was soon changed to 4 x TwoCal Bolus daily.
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His dietitian set the following nutritional goals for Fred:
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Fred remains settled on this regimen and no longer experiences symptoms of gastrointestinal intolerance.
His dietitian reports ‘By getting his calories in a small volume via bolusing with TwoCal Bolus 200 ml 4 times a day, which he tolerates well, his weight is now slowly increasing and he is able to maintain his quality of life’.
She adds ‘Fred is very happy. He feels he is able to do the things he loves – walking, gardening and the occasional trip to the local pub to socialise. He feels stronger since he was changed to bolus feeding with TwoCal Bolus 200 ml, 4 times daily.
Athanasia Papalamprou, Community dietitian, London
Martin is a 74-year-old retired gentleman with a grown-up daughter. He is currently living in his own home in Rochdale with the support of his daughter and daily carers for his hygiene needs.
Sue is a 42 year old female patient with a subtotal colectomy and ileostomy.
Arnold is an 82 year old male patient with a ruptured oesphagus and dysphagia.
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ENSURE PLUS
1 x 220 ml
Flavor: Apple
1,5 kcal / ml
Nutrition Information
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| Unit | Per {ml-col-1} ml | Per {ml-col-2} ml |
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UK-N/A-2200465 | July 2022
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