Addressing nutritional failure in a cystic fibrosis patient using nutritional and psychological intervention

Abstract

Background: Malnutrition is associated with Cystic Fibrosis (CF) disease progression. That contributes to decreased lung function, poor quality of life, and increased morbidity and mortality. Appetite stimulants (AS) have been used to help increase caloric intake. When caloric intake is inadequate, gastrostomy tube (GT) feeding is offered and has shown to improve weight gain. In some patients, both AS and GT placement might not be adequate to insure weight gain. That could be due to the underlying psychopathological issues like anxiety and depression that are common in CF.

Aim: To address malnutrition in CF.

Method: Since increasing oral caloric intake was inadequate to improve weight gain. AS and GT feeding were discussed and offered. AS was started, but was not used regularly. However, GT was still needed to improve weight gain. Because of patient's hesitations, ongoing psychological counseling was done to help patient accept the intervention.

Results: Addressing patient's depression and anxiety and the failure to gain adequate weight at the same time helped improving patient's nutritional status.

Conclusion: The presented case report demonstrates the improvement in weight gain and body mass index in a CF patient after addressing both the patient's psychological needs and increasing caloric intake through gastrostomy tube feeding.

Keywords: Appetite stimulants; Cystic fibrosis; Gastrostomy tube feeding; Malnutrition; Psychological counseling.