Blenderized food tube feeding in patients with head and neck cancer

Abstract

Background Patients with headand neck cancer (HNC) are at high risk for malnutrition before and during chemoradiation treatment. Many will also require tube feeding to address declines in energy intake, weight, and quality of life (QOL) caused by the impact of treatment on gastrointestinal (GI) symptoms. Blenderized tube feeding (BTF) may ameliorate these adverse conditions. Methods In this open‐label, prospective pilot study, 30 patients with HNC who required feeding tube placement were recruited to switch from standard commercial formula after 2 weeks to a commercially prepared BTF formula. Weight, body mass index (BMI), GI symptoms, and QOL scores were tracked for 6 weeks from the first week of feeding tube placement. Results Of the 16 patients who completed the 6‐week assessment period, weights and BMI scores for 15 patients trended upward. For most patients, QOL and oral intake increased and GI symptoms decreased over the 6‐week period, particularly during weeks 3 and 4, when the impact of treatment is particularly exacting on patients with HNC. Conclusion BTF effectively mitigated weight loss, GI symptoms, QOL scores, and total energy intake in this group of patients with HNC who received tube feeding for 6 weeks.

A systematic review examining the impact of blended diets on the gastrointestinal symptoms of people who are enterally fed

“…48 Furthermore, a prospective observational cohort study reported significant decrease in diarrhoea post-BD intervention (either homemade BD or commercial sterile BD) using the PedsQL GIS Scale (from 87.9 to 73.6, p = 0.004). 46 Further evidence of improved symptoms of diarrhoea on BD is found in an open-label, prospective pilot study of adults with head and neck cancer by Spurlock et al 49 This study was published after searches were concluded, and the findings are congruous with this review. 49 This small yet compelling study found 37.5% of participants (n = 16) reported diarrhoea on CFF, reducing to 0% on transition to BD.…”

“…49 This small yet compelling study found 37.5% of participants (n = 16) reported diarrhoea on CFF, reducing to 0% on transition to BD. 49 Tellingly, all participants elected to remain on BD thereafter, and those reporting 'good' or 'very good' quality of life increased from 50.1% before to 91.3% after BD intervention. 49 The quality of life of people who are enterally fed may be negatively affected by GIS such as diarrhoea, therefore optimising symptom control is a logical step.…”

“…49 Tellingly, all participants elected to remain on BD thereafter, and those reporting 'good' or 'very good' quality of life increased from 50.1% before to 91.3% after BD intervention. 49 The quality of life of people who are enterally fed may be negatively affected by GIS such as diarrhoea, therefore optimising symptom control is a logical step. 50 Although well documented in anecdotal literature, 5 Spurlock et al 49 add robust quantitative evidence to suggest improved symptoms of diarrhoea and quality of life for patients switching from CFF to BD.…”

Low risk for microbial contamination of syringe and tube feeding bag surfaces after multiple reuses with home blenderized tube feeding

“…These concerns may be due in part to the fact that most published studies report high bacterial contamination in BTF, but these findings have been challenged in two recent articles showing that BTF can be safely prepared in the hospital and home environment 9,10 . In spite of concerns by healthcare professionals, emerging research has corroborated the anecdotal reports of patients and caregivers attesting that BTF reduces tube feeding intolerance (gagging, retching, vomiting, diarrhea, constipation, and volume intolerance), supports weight/growth goals, increases oral intake in patients deemed safe for swallowing, reduces infection and hospitalization, and provides a more physiologic feeding 21–28 . Consequently, research on methods of minimizing risk of microbial infection in the HEN population is paramount, particularly for those using HBTF.…”

“…9,10 In spite of concerns by healthcare professionals, emerging research has corroborated the anecdotal reports of patients and caregivers attesting that BTF reduces tube feeding intolerance (gagging, retching, vomiting, diarrhea, constipation, and volume intolerance), supports weight/growth goals, increases oral intake in patients deemed safe for swallowing, reduces infection and hospitalization, and provides a more physiologic feeding. [21][22][23][24][25][26][27][28] Consequently, research on methods of minimizing risk of microbial infection in the HEN population is paramount, particularly for those using HBTF.…”