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Today in Health & Wellness
DOCTOR AT THE DESK

Feeding the Sick

"Why it is hard to eat and the issue on liquids"
By: Lourdes Nena A. Cabison-Carlos, MDFeeding the Sick

A buffet of flavorful dishes is enough to make anyone’s mouth water—but it means nothing to someone who’s sick. Are you familiar with that bitter taste at the back of the mouth every time you’re feeling under the weather? While sometimes it’s because of a medicine’s aftertaste, it could also be attached to several factors which come with the whole brouhaha of not feeling well. 

We need food in sickness and in health—that much is obvious. Needless to say, when a person is sick, the need for nutrients is even greater. In addition, energy is expended to help keep the body functioning, fight infections, and replace the nutrients lost through illness.

The action of inflammatory chemicals and other substances released during illness results in a complicated interplay with the body’s natural hormones and function. Children, when compared with healthy adults, are more prone to develop malnutrition and nutrient deficiency—or if already present, present with worse cases—because they are in general more difficult to feed, are dependent on adults for food, and have high basal metabolic rates and smaller energy reserves. And when the “excess demand” for energy is not met, sick people use their own stores of body fat and muscles as source of energy. Therefore, it is little wonder why sick people tend to lose weight.

  • Fever - the body uses more water than usual.
  • Gastroenteritis - the fluid deficit is exacerbated by the loss of water and electrolytes through diarrhea and vomiting.

It is then important that water is replaced accordingly. Liquids should be offered more frequently.

Giving fluids to the sick

  • Clean boiled water,
  • fresh fruit juices,
  • soups, or broth
  • Reformulated oral rehydration (ORS) - best for individuals with diarrhea and vomiting and are readily available at your nearest drugstore. It is given after every bout of LBM (loose bowel movement) or 30 minutes after vomiting and is very effective in preventing dehydration.
  • If a breastfed infant is sick, it is best to continue breastfeeding.

A crude but easy way of knowing whether you have given enough water is by counting the number of times your patient or ward goes to the bathroom to pee—which should usually be about once every 4 to 6 hours.

Giving food to the sick

  • Soup
  • bread, biscuits,
  • oatmeal, porridge,
  • fruits like banana or apple
  • Chicken noodle soup helps because the broth is a source of fluid, the chicken of protein, and the noodles of carbohydrates.
  • pureed or soft food and cool liquids for little kids with mouth sores, dry, salty

Giving food is similar to giving fluids; that is, in small quantities at frequent intervals. The end goal is to get food in the intestines based on what is tolerated. 

Herbal food supplements

  • Benefits of micronutrient supplementation especially during illness have been established.
  • Zinc has been proven to shorten the duration and frequency of diarrhea.
  • Probiotics (the good bacteria found in healthy intestines) are also used in diarrhea and are now being investigated for use in other common diseases.
  • Vitamin A has long been given to patients with measles.
  • Because of their inherent properties, certain micronutrients like zinc, selenium, iron, manganese, glutathione, and vitamins are able to combat oxidant stress during injury or illness.

Taking mega doses of these vitamins and minerals does little good, however, and sometimes even harms the body. What does this mean for us? It means that it is okay to continue taking multivitamins during illness but a physician’s advice regarding the need for specific micronutrient supplementation must be sought. A prescription from your well-meaning neighbor is a no-no.

 

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