Refeeding syndrome: Difference between revisions
From WikiMD's Wellness Encyclopedia
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{{Infobox medical condition | |||
| name = Refeeding syndrome | |||
| image = [[File:The_Liberation_of_Bergen-belsen_Concentration_Camp,_April_1945_BU4007.jpg|250px]] | |||
| caption = Emaciated survivors of [[Bergen-Belsen concentration camp]] during liberation, a context where refeeding syndrome can occur. | |||
| field = [[Endocrinology]], [[Nutrition]] | |||
| synonyms = | |||
| symptoms = [[Electrolyte imbalance]], [[hypophosphatemia]], [[hypokalemia]], [[hypomagnesemia]], [[edema]], [[cardiac arrhythmias]], [[seizures]] | |||
| complications = [[Heart failure]], [[respiratory failure]], [[rhabdomyolysis]], [[delirium]] | |||
| onset = Within 4 days of refeeding | |||
| duration = Variable, depending on management | |||
| causes = Rapid refeeding after periods of malnutrition or starvation | |||
| risks = [[Anorexia nervosa]], [[chronic alcoholism]], [[prolonged fasting]], [[malabsorption syndromes]], [[cancer]] | |||
| diagnosis = Clinical assessment, monitoring of electrolyte levels | |||
| differential = [[Electrolyte imbalance]], [[heart failure]], [[sepsis]] | |||
| prevention = Gradual refeeding, monitoring of electrolytes | |||
| treatment = Electrolyte replacement, careful monitoring, gradual increase in caloric intake | |||
| prognosis = Good with appropriate management | |||
| frequency = Common in at-risk populations | |||
| deaths = Rare with proper treatment | |||
}} | |||
'''Refeeding syndrome''' (RFS) is a potentially serious metabolic condition that can arise when nutrition is reintroduced to severely malnourished individuals. This syndrome is characterized by an imbalance of water-electrolytes, glucose intolerance, cardiac arrhythmias, and diarrhea, typically occurring within the first five days of refeeding.<ref>{{Cite journal |last=Mehanna |first=HM |title=Refeeding syndrome: what it is, and how to prevent and treat it |journal=BMJ |volume=336 |issue=7659 |pages=1495-1498 |year=2008 |doi=10.1136/bmj.a301}}</ref> | '''Refeeding syndrome''' (RFS) is a potentially serious metabolic condition that can arise when nutrition is reintroduced to severely malnourished individuals. This syndrome is characterized by an imbalance of water-electrolytes, glucose intolerance, cardiac arrhythmias, and diarrhea, typically occurring within the first five days of refeeding.<ref>{{Cite journal |last=Mehanna |first=HM |title=Refeeding syndrome: what it is, and how to prevent and treat it |journal=BMJ |volume=336 |issue=7659 |pages=1495-1498 |year=2008 |doi=10.1136/bmj.a301}}</ref> | ||
==Understanding Refeeding Syndrome== | ==Understanding Refeeding Syndrome== | ||
The hallmark of refeeding syndrome is a shift in fluids and electrolytes in a malnourished individual who receives nutritional supplementation. This shift can lead to severe complications such as heart failure, respiratory failure, and death if not recognized and managed promptly. | The hallmark of refeeding syndrome is a shift in fluids and electrolytes in a malnourished individual who receives nutritional supplementation. This shift can lead to severe complications such as heart failure, respiratory failure, and death if not recognized and managed promptly. | ||
==Causes and Risk Factors== | ==Causes and Risk Factors== | ||
The primary cause of RFS is the reintroduction of glucose, or carbohydrates, to a severely malnourished individual. Risk factors include prolonged fasting, low BMI, significant unintentional weight loss, and underlying chronic diseases such as cancer and chronic gastrointestinal diseases.<ref>{{Cite journal |last=Rio |first=A |title=Refeeding syndrome: clinical and nutritional relevance |journal=Endocrinol Diabetes Nutr |volume=65 |issue=6 |pages=320-327 |year=2018 |doi=10.1016/j.endinu.2018.01.009}}</ref> | The primary cause of RFS is the reintroduction of glucose, or carbohydrates, to a severely malnourished individual. Risk factors include prolonged fasting, low BMI, significant unintentional weight loss, and underlying chronic diseases such as cancer and chronic gastrointestinal diseases.<ref>{{Cite journal |last=Rio |first=A |title=Refeeding syndrome: clinical and nutritional relevance |journal=Endocrinol Diabetes Nutr |volume=65 |issue=6 |pages=320-327 |year=2018 |doi=10.1016/j.endinu.2018.01.009}}</ref> | ||
==Symptoms== | ==Symptoms== | ||
Symptoms of RFS can vary widely and may include fatigue, muscle weakness, seizures, heart failure, and even coma. | Symptoms of RFS can vary widely and may include fatigue, muscle weakness, seizures, heart failure, and even coma. | ||
==Diagnosis== | ==Diagnosis== | ||
The diagnosis of RFS is often clinical, made by observing the patient's response to nutritional reintroduction. However, blood tests are essential to monitor electrolyte levels, especially phosphorus, magnesium, and calcium.<ref>{{Cite web |title=Refeeding Syndrome |url=https://www.uptodate.com/contents/refeeding-syndrome |publisher=UpToDate |access-date=2023-05-18}}</ref> | The diagnosis of RFS is often clinical, made by observing the patient's response to nutritional reintroduction. However, blood tests are essential to monitor electrolyte levels, especially phosphorus, magnesium, and calcium.<ref>{{Cite web |title=Refeeding Syndrome |url=https://www.uptodate.com/contents/refeeding-syndrome |publisher=UpToDate |access-date=2023-05-18}}</ref> | ||
==Management== | ==Management== | ||
Management of RFS requires careful monitoring and correction of electrolyte imbalances, along with gradual, controlled reintroduction of nutrients. In some cases, intravenous electrolyte replacement may be necessary.<ref>{{Cite journal |last=Sriram |first=K |title=The refeeding syndrome and its current clinical implications |journal=JPEN J Parenter Enteral Nutr |volume=37 |issue=4 |pages=462-70 |year=2013 |doi=10.1177/0148607113476583}}</ref> | Management of RFS requires careful monitoring and correction of electrolyte imbalances, along with gradual, controlled reintroduction of nutrients. In some cases, intravenous electrolyte replacement may be necessary.<ref>{{Cite journal |last=Sriram |first=K |title=The refeeding syndrome and its current clinical implications |journal=JPEN J Parenter Enteral Nutr |volume=37 |issue=4 |pages=462-70 |year=2013 |doi=10.1177/0148607113476583}}</ref> | ||
==See Also== | ==See Also== | ||
* [[Malnutrition]] | * [[Malnutrition]] | ||
* [[Anorexia nervosa]] | * [[Anorexia nervosa]] | ||
| Line 30: | Line 39: | ||
[[Category:Nutritional disorders]] | [[Category:Nutritional disorders]] | ||
[[Category:Syndromes]] | [[Category:Syndromes]] | ||
Latest revision as of 05:43, 6 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC
| Refeeding syndrome | |
|---|---|
| |
| Synonyms | |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Electrolyte imbalance, hypophosphatemia, hypokalemia, hypomagnesemia, edema, cardiac arrhythmias, seizures |
| Complications | Heart failure, respiratory failure, rhabdomyolysis, delirium |
| Onset | Within 4 days of refeeding |
| Duration | Variable, depending on management |
| Types | N/A |
| Causes | Rapid refeeding after periods of malnutrition or starvation |
| Risks | Anorexia nervosa, chronic alcoholism, prolonged fasting, malabsorption syndromes, cancer |
| Diagnosis | Clinical assessment, monitoring of electrolyte levels |
| Differential diagnosis | Electrolyte imbalance, heart failure, sepsis |
| Prevention | Gradual refeeding, monitoring of electrolytes |
| Treatment | Electrolyte replacement, careful monitoring, gradual increase in caloric intake |
| Medication | N/A |
| Prognosis | Good with appropriate management |
| Frequency | Common in at-risk populations |
| Deaths | Rare with proper treatment |
Refeeding syndrome (RFS) is a potentially serious metabolic condition that can arise when nutrition is reintroduced to severely malnourished individuals. This syndrome is characterized by an imbalance of water-electrolytes, glucose intolerance, cardiac arrhythmias, and diarrhea, typically occurring within the first five days of refeeding.<ref>Mehanna, HM,
Refeeding syndrome: what it is, and how to prevent and treat it, BMJ, 2008, Vol. 336(Issue: 7659), pp. 1495-1498, DOI: 10.1136/bmj.a301,</ref>
Understanding Refeeding Syndrome[edit]
The hallmark of refeeding syndrome is a shift in fluids and electrolytes in a malnourished individual who receives nutritional supplementation. This shift can lead to severe complications such as heart failure, respiratory failure, and death if not recognized and managed promptly.
Causes and Risk Factors[edit]
The primary cause of RFS is the reintroduction of glucose, or carbohydrates, to a severely malnourished individual. Risk factors include prolonged fasting, low BMI, significant unintentional weight loss, and underlying chronic diseases such as cancer and chronic gastrointestinal diseases.<ref>Rio, A,
Refeeding syndrome: clinical and nutritional relevance, Endocrinol Diabetes Nutr, 2018, Vol. 65(Issue: 6), pp. 320-327, DOI: 10.1016/j.endinu.2018.01.009,</ref>
Symptoms[edit]
Symptoms of RFS can vary widely and may include fatigue, muscle weakness, seizures, heart failure, and even coma.
Diagnosis[edit]
The diagnosis of RFS is often clinical, made by observing the patient's response to nutritional reintroduction. However, blood tests are essential to monitor electrolyte levels, especially phosphorus, magnesium, and calcium.<ref>
Refeeding Syndrome(link). {{{website}}}. UpToDate.
Accessed 2023-05-18.
</ref>
Management[edit]
Management of RFS requires careful monitoring and correction of electrolyte imbalances, along with gradual, controlled reintroduction of nutrients. In some cases, intravenous electrolyte replacement may be necessary.<ref>Sriram, K,
The refeeding syndrome and its current clinical implications, JPEN J Parenter Enteral Nutr, 2013, Vol. 37(Issue: 4), pp. 462-70, DOI: 10.1177/0148607113476583,</ref>
