Oesophageal disorders can impact locally on food delivery to the stomach
while gastric disorders can interfere with reservoir function and chemical digestion.
These restrictive disorders prevent anabolism and contribute to catabolism in order to
maintain function. However, many oesophago-gastric disorders can impact on the
energy balance through their systemic effects such as sepsis or cancer cachexia as two
notable examples. These are catabolic disorders and despite adequate intake
malnutrition is the end result. Malnutrition is prevalent in most patients with
oesophago-gastric disorders particularly in patients with cancers of the oesophagus or
stomach. In addition, the effects of therapeutic modalities delivered to the oesophagus
or stomach such as surgery, chemo and radiotherapy can also influence a catabolic state
either directly or indirectly. The local, systemic and therapeutic effects on energy
balance have to be addressed by a thorough screening, assessment, appropriate therapy
and continuous monitoring of nutritional status.
All patients with reduced oral intake and / or weight loss as a result of mechanical or
functional obstruction in the oesophagus or stomach should be screened and referred
for dietetic assessment and management if appropriate. The overall goal of dietetic
therapy in oesophago-gastric disorders is to address the energy imbalance, restore the
energy requirements and improve symptoms in order to maintain function and survival.
Keywords: Cancer cachexia, Dumping syndrome, Energy balance, Enteric
nutrition, Nutrition, Malnutrition, Risk assessment, Nutritional requirements, Oral
nutrition supplements, Parenteral nutrition.
