Abstract
The incidence of upper gastrointestinal (UGI) bleeding and the effect of nutritional support was studied retrospectively in 166 spinal cord injured patients. Sixty six patients included in group 1 were started on oral diet when 'clinically ready' which resulted in a haphazard manner for provision of nutrition. One hundred patients in group 2 were treated according to an organised nutrition protocol. The protocol initiates total parental nutrition (TPN) if the patient is not tolerating an oral diet by day 5. All group 2 patients met their total energy requirements (TER) within 48 hours after initiating caloric supplementation.
The overall incidence of acute acid peptic ulceration leading to significant bleeding or perforation was 4%. Five of the 66 group 1 patients (7.5%) and 2 of the 100 group 2 patients (2%) developed acute ulcerations. While the exact mechanism remains unclear, this significant (p < 0.05) reduction indicates that a nutritional regimen that meets a patients TER decreases the likelihood of acid peptic complications after spinal cord injury.
Similar content being viewed by others
Article PDF
References
El Masri W, Cochrane P, Silver J R 1982 Gastrointestinal bleeding in patients with acute spinal injuries. Injury 14: 161–167.
Epstein N, Hood D C, Ransohoff J 1981 Gastrointestinal bleeding in patients with spinal cord trauma. Journal of Neurosurgery 54: 16.
Globus J H, Ralston B L 1951 Multiple erosions and acute perforations of the esophagus, stomach, and duodenum in relation to disorders of nervous system.’ Journal Mt Sinai Hospital 17: 817.
Gore R M, Mintzer R A, Calenoff L 1981 Gastrointestinal complications of spinal cord injury. Spine 6: 538–544.
Kewalramani L S 1979 Neurogenic gastroduodenal ulceration and bleeding associated with spinal cord injuries. Trauma 19: 259–265.
Kiwerski J. 1986 Bleeding from the alimentary canal during the management of spinal cord injury patients. Paraplegia 24: 92–96.
Miller L S, Stass W E, Herbison G J 1975 Abdominal problems in patients with spinal cord lesions. Archives of Physical Medicine and Rehabilitation 56: 405–408.
Moolten S E 1942 Duodenal ulcer following acute injury of the spinal cord. Journal Mt Sinai Hospital 8: 868.
Soderstrom C A, Ducker T B 1985 Increased susceptibility of patients with cervical cord lesions to peptic gastrointestinal complications. The Journal of Trauma 25: 1030–1036.
Walters K, Silver S R 1986 Gastrointestinal bleeding in patients with acute spinal injuries. International Rehabilitation Medicine 8: 44–48.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kuric, J., Lucas, C., Ledgerwood, A. et al. Nutritional support: a prophylaxis against stress bleeding after spinal cord injury. Spinal Cord 27, 140–145 (1989). https://doi.org/10.1038/sc.1989.21
Issue Date:
DOI: https://doi.org/10.1038/sc.1989.21
Keywords
This article is cited by
-
Stress Ulcer Prophylaxis in Neurocritical Care
Neurocritical Care (2018)
-
Gastrointestinal Prophylaxis in Neurocritical Care
Neurocritical Care (2012)