A83 plant-based enteral nutrition: a potential method of secretion management in a palliative patient with progressive myotonic dystrophy — a case report
Abstract
Abstract Background Degenerative neuromuscular conditions such as myotonic dystrophy is characterized by oropharyngeal dysfunction leading to reduced ability to eat orally and clear respiratory secretions. Enteral nutrition (EN) is often required in these patients but aspiration pneumonia remains a concern. Dairy-based EN are commonly used, but evidence suggests that casein digestion may stimulate mucin production in respiratory tissues, increasing secretions (Bartley 2010). McClanahan et al. (2019) showed that switching patients to plant-based EN improved gastrointestinal outcomes and reduced medication use in chronically ill, tube-fed children. Viall et al. (1990) found soy-based EN led to fewer gastrointestinal issues, such as vomiting and gastric residuals, compared to casein-based EN. Goelen et al. (2021) also reported that plant-based EN resulted in faster gastric emptying compared to casein-based EN, which could reduce secretion-related complications. Aims To describe nutrition management in a palliative patient with myotonic dystrophy with recurrent aspiration pneumonia. Methods Case report. Results A patient with myotonic dystrophy type 1, was admitted with viral respiratory infection resulting in respiratory failure and prolonged hospitalization with marked deterioration in respiratory and swallowing functions. A nasogastric and then percutaneous gastrostomy feeding tubes were placed but feeding regimens remained suboptimal (50% caloric provision) due to recurrent…
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