Nutritional Implications of Hepatointestinal Disorders
While reduced intake in malignant diseases of the esophagus and upper stomach may be due primarily to mechanical obstruction to swallowing, the effects of the tumor itself on appetite and the psychological aspects of having cancer may also decrease appetite and food intake. In addition to oropharyngeal, esophageal and gastric neoplasms, alcohol intake, particularly in the form of beer, is associated with colorectal carcinomas. Balance studies in patients secreting less than 10% of normal pancreatic enzymes in response to CCK eating 32 kcal/kg of which 100 g was fat and an unspecified amount was nitrogen were reported. The nutritional management of the alcoholic patient can for the most part be summarized as the cessation of the alcohol and the encouragement of a well-balanced diet. Glycogen storage will be impaired with major implications for physical endurance. The micronutrient defects may be associated with specific deficiency syndromes, the best known of which are the Wernicke/Korsakoff syndromes.