Structured Review of the Value Added by the Registered Dietitian to the Care of Gastrointestinal Cancer Patients

Abstract

Background Malnutrition is common among patients with gastrointestinal (GI) cancer and contributes to their morbidity and mortality. Nutrition interventions provided by a registered dietitian (RD) or dietitian may improve nutrition status and patient outcomes; however, there are few studies that attempt to define the contribution of the dietitian to these outcomes. Objective Our objective was to identify the value added by the dietitian to the care of patients with GI malignancies. Methods A structured review was conducted using PubMed, CINAHL, Scopus, Medline, and ClinicalKey (all dates up to December 2019). Patients included those with GI malignancies undergoing cancer treatment and receiving intervention provided by an dietitian. Intervention included provision of medical nutrition therapy by an dietitian in the form of counseling, diet advice, oral nutritional supplementation, and enteral and/or parenteral nutrition–directed recommendations. Results Ten relevant studies were identified and included for analysis. Studies suggest that nutrition counseling by a dietitian during cancer treatment results in improved weight maintenance and energy intake. Preoperative nutrition counseling and inpatient dietitian intervention seem to decrease length of stay after major surgery. Conclusions We conclude that the dietitian, especially when providing nutrition counseling, improves the nutrition‐related outcomes of patients with GI malignancies. The small number of existent studies highlights the need for further research to define the impact of dietitian interventions and to determine which particular interventions best improve patient outcomes.

Preoperative Nutrition Intervention in Patients Undergoing Resection for Upper Gastrointestinal Cancer: Results from the Multi-Centre NOURISH Point Prevalence Study

“…Dietitians are well placed to provide medical nutrition therapy (MNT) and individualised nutrition care to patients with UGI cancer, whilst liaising with surgeons and oncologists regarding symptom management and escalation of nutrition support. Several reviews have demonstrated that intervention by a dietitian improves nutrition-related outcomes and LOS in gastrointestinal cancer surgery [ 20 , 21 , 22 ]. Considering that guidelines recommend all cancer patients who are high risk of malnutrition receive assessment by a dietitian [ 23 ], it is concerning that 39% of the NOURISH cohort reported never having met with a dietitian before surgery.…”

Nutrition Intervention in a Gastric Cancer Patient With Gastrectomy for 12 Months: A Case Report

“…For effective nutritional intervention, individualized nutrition counselling is needed because it takes into consideration of patient preferences and specific treatment-related side effects that affect nutritional intake. Periodic follow-up during the first year after surgery is beneficial to the patient, and intensive nutrition education is suggested to be more effective in improving nutritional status, dietary intake, and quality of life than one-time education [ 4 5 6 ].…”