Refeeding Syndrome

Refeeding syndrome is a common but under recognized condition.

Many at-risk patients such as chronic alcoholism, liver disease, chronic pancreatitis, perioperative patients (bowel strictures, IBD, Koch’s), GI cancer (chemoradiotherapy), patients referred for feeding access, will come to GI service.

The key problems of refeeding are hypophosphatemia, thiamine defi ciency, salt and water retention (edema/left ventricular failure). Hypophosphatemia is a life-threatening problem.

Neuropsychiatric manifestations may occur due to thiamine defi ciency (Wernicke’s encephalopathy).

NG feeding – higher risk than those given IV fl uids or parenteral nutrition.

Baseline evaluation includes labs (blood counts, electrolytes, phosphates, calcium, magnesium), liver biochemistry, KFT, sepsis screen, ECG, Echo, NT-proBNP, chest X-ray and ultrasound.

Do not rush to give carbohydrates, exercise caution regarding fl uids. Document feeding protocol, adhere to it and audit periodically.


Medtalks is India's fastest growing Healthcare Learning and Patient Education Platform designed and developed to help doctors and other medical professionals to cater educational and training needs and to discover, discuss and learn the latest and best practices across 100+ medical specialties. Also find India Healthcare Latest Health News & Updates on the India Healthcare at Medtalks