Renourishment

Renourishment is the process of restoring nutrition to someone who has experienced severe starvation for a period of time. In North America, malnourished patients with various medical concerns such as cancer, alcoholism, and swallowing difficulties due to neurological concerns, as well as anorexia nervosa should receive carefully monitored renourishment. It is important to provide the right sort of nutrition as well as the appropriate number of calories in order to avoid serious metabolic disturbances known as refeeding syndrome.

Renourishment should ideally be provided within special hospital units where the facilities for frequent monitoring and specialized treatment are readily available. Blood tests to measure serum phosphate levels may be conducted, with intravenous phosphate treatment available should it be required. Electrolyte abnormalities may also be detected, requiring special nutritional support and intravenous supplementation. As phosphate, magnesium and potassium levels may drop further when patients start to receive nourishment, it is important to ensure that the plasma levels of these vital electrolytes are sufficient. Micronutrient deficiencies may also be addressed.

During renourishment, patients should receive special feeding regimes according to their individual needs. Generally, this entails the provision of approximately 10 calories per kilogram in weight every 24 hours, for the first critical 48 hours, or 50 – 70 percent of normal energy intake, for the first 3 – 5 days. During this time, fluid balance should be monitored and corrected if necessary. Renourishment involves increasing feeding slowly in order to allow the patient time to adjust, as the body switches from using stored fat reserves to the process of digesting food.

Sometimes individuals are given milk during the early stages of renourishment, as it is naturally high in phosphates, helping to address any concerns regarding hypophosphatemia. Milk is also easy to digest and generally well tolerated by most people. Special formulations are also available for those who require more specialized nutritional support. Patients progress to a soft food diet, and then a carefully supervised regular diet. Individuals recovering from anorexia may also require medication to control acid, as well as promote gastrointestinal motility in order to relieve the distressing symptoms of abdominal discomfort.