Nutrition management for poor oral intake in patients with gastroesophageal junction adenocarcinoma

Abstract

Patients with gastroesophageal (GE) junction adenocarcinoma experienced the symptoms such as poor appetite, dysphagia and early satiety, impacting dietary intake leading to insufficient protein–energy intake. A 63-year-old Malay male, diagnosed with GE junction adenocarcinoma and anaemia, was admitted for chemotherapy and referred to a dietician to enhance oral intake and nutritional status. Experiencing unintentional weight loss over 3 months due to progressive dysphagia and reduced appetite, the patient was underweight. Low levels of albumin and creatinine indicated inadequate oral intake, an acute-phase response to cancer and muscle loss, respectively. Solely relying on oral nutritional supplements (ONSs) for nourishment, the estimated energy and protein intake were only 47.1% and 47.6% (0.57 g/kg body weight), respectively, in relation to requirements. A full liquid diet was prescribed, and nutrition counselling focused on strategies to increase protein–energy intake, stressing its importance in addressing the ongoing catabolic state. During follow-up, the patient showed improved energy and protein intake, reaching 78% and 81%, respectively, meeting requirements.