Nutrition impact symptoms, handgrip strength and nutritional risk in hospitalized patients with gastroenterological and liver diseases

Abstract

Objective: Malnutrition is common among patients with diseases of the liver and gastrointestinal tract. Nutritional intake may be negatively affected by nutrition impact symptoms (NIS). Therefore, the aims were to assess: 1) the prevalence of NIS in this group of patients and 2) the relationship between NIS and nutritional status as well as nutritional risk.

Material and methods: We performed a cross-sectional study among patients with liver disease, inflammatory bowel disease, cancer or pancreatitis. Nutritional risk was assessed by the NRS-2002. Nutritional status was assessed by body mass index (BMI) and handgrip strength (HGS), which were both measured within 5 days after admission. NIS were assessed by the Eating Symptoms Questionnaire (ESQ) and the Disease-Related Appetite Questionnaire (DRAQ).

Results: In total, 126 patients were included (women 39%) with a mean BMI of 24 ± 5 kg/m(2). The prevalence of low HGS was 38%, and the prevalence of those at nutritional risk was 58%. The number of NIS reported by 50% of the patients were 4 or more in the ESQ and 5 or more in the DRAQ. Patients who were both at nutritional risk and had a low HGS more frequently reported difficulties swallowing, poor appetite, feeling full after having one-fourth of the meal and food tasting bad.

Conclusions: NIS that preclude food intake are very frequent among patients with diseases of the liver and gastrointestinal tract. Specific NIS are associated with low HGS, weight loss and being at nutritional risk.

Keywords: appetite; gastrointestinal cancer; inflammatory bowel disease; liver disease; pancreatitis; stomachache.