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31 August 2023 : Case report  Poland

[In Press] Successful Use of an Exclusion Diet with Partial Enteral Nutrition in a Patient After Total Gastrectomy: A Case Report

Unusual or unexpected effect of treatment, Unexpected drug reaction

Daria Bieniek-Bruzdowicz ORCID logo12ABDEFG, Marcin Mrozowski ORCID logo34BG, Małgorzata Szamocka ORCID logo12EG, Maria Kłopocka ORCID logo12DEFG

DOI: 10.12659/AJCR.940107

Am J Case Rep In Press; DOI: 10.12659/AJCR.940107  

Available online: 2023-08-31, In Press, Corrected Proof

Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule


Gastric cancer is the 5th most common malignancy worldwide. Treatment consists of excision of the entire stomach. Malnutrition is a common problem in patients diagnosed with gastric cancer and has a negative impact on the course of treatment and the quality of life.
The paper presents a case report of a patient after total gastrectomy performed on 11/04/2016 due to G3 mucocellulare carcinoma. The patient had been on home parenteral nutrition for 2.5 years due to chronic malnutrition. After this period of time, an attempt was made to introduce an exclusion diet with the addition of Modulen IBD (Nestle Health Science), which is routinely used in the nutritional treatment of patients with Crohn’s disease, with simultaneous discontinuation of parenteral nutrition.
After 3 months, the patient was readmitted to the hospital to assess his nutritional status. He continued the diet as recommended. He maintained his body weight and reported improvement in eating habits.
In the described case, the patient presented with symptoms of impaired bowel function resulting from long-term cessation of oral nutrition. It is possible that the nutritional and immunomodulatory effect of Modulen, in combination with the anti-inflammatory elimination diet, resulted in better nutrition of intestinal epithelial cells and gradual improvement of intestinal motility and absorption, which in turn enabled the patient to completely withdraw from parenteral nutrition. We propose that this type of nutritional management could also be considered in other cases of intestinal dysfunction.

Keywords: Postgastrectomy Syndromes; Malnutrition; Enteral Nutrition; Nutrition Disorders; Nutrition Therapy

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923