Clinical nutrition in the hepatogastroenterology curriculum

Table 2 Elements of the suggested modular teaching program on clinical nutrition for hepatogastroenterology specialists

Knowledge of key issues in nutrition

GI physiology

Anatomy

Digestion

Absorption

Motility

GI endocrinology/hormones

Physiology and metabolism of body composition, energy homeostasis

In health

Satiety/needs, calculations, measurements, techniques

Concerning:

Fat

Carbohydrates

Protein

Energy

Micro elements/vitamins

Starvation: Differential diagnostics and clinical management

Obesity: see below

Interventions

Artificial nutrition

Tube feeding/Enteral/PEG tube insertion

Parenteral nutrition

Administration:

access techniques and complications

Complications and safety

Risk-benefit analysis

Enteral nutrition

Parenteral nutrition

Normal (per oral) feeding

Feeding and artificial orificia

Use of nutrition with stress metabolism

Pathophysiology of digestion

Diseases of digestion and absorption

Diseases of impaired nutrient delivery

Protein-losing enteropathies

Pathophysiology of metabolism

Stress metabolism

Metabolism in Critical Illness

Nitrogen wasting

Genetic Metabolic disorders (e.g., OTC)

Special Diets

Nutrition and psychology

Role of psychological issues

Specific clinical situations

Kidney and liver disease

Catabolism/malnutrition

Cancer

Inflammation

Use of PN

Indications

Designing a formula

Monitoring for complications

Techniques

Feeding tubes: nasogastric/nasojejunal

PEG/PEJ/PRG

PEG-J

Jejunostomy [surgically created (Witzel’s) fistula or needle jejunostomy]

Central venous access: (tunnelled) catheters

Peripherally inserted central catheters (PICC)

Subcutaneous ports/arteriovenous fistulae (shunts)