Overview of nutritional approach in hematopoietic stem cell transplantation: COVID-19 update

Table 3 Nutritional approach in specific complications

Special complications	Nutritional approach
Vomiting/nausea	Developing a diet plan which includes salty or sour foods, cold and clear liquids, small frequent meal portions, low-fat and low-fiber foods
	Starting parenteral nutrition or postpyloric enteral nutrition if symptoms are severe
Dysgeusia	Promotion of good oral hygiene
	Developing a diet plan which includes a variety of highly spicy, tasty foods (unless mucositis/esophagitis) to optimize oral intake
Xerostomia	Development of a diet plan which includes the use of highly-moist foods, saliva stimulants (e.g. citric acid drinks, sugarless sugar, sugar-free gum) to optimize oral intake
	Supplementation with additional oral or IV fluids as needed
	Making a saliva substitute
Mucositis	Developing a diet plan with varying texture/temperature foods and drinks in addition to providing adequate vitamin/mineral supplements to optimize oral intake
	Consideration of enteral or parenteral nutrition if oral intake is insufficient
Diarrhea	Discontinuing oral intake if stool exceeds approximately 2000 mL/d for several days
	Consideration of parenteral nutrition in prolonged lack of oral intake
	Intake of soluble fiber
	Maintaining a low lactose diet and prescribing lactase enzymes in the presence of lactose intolerance
	Developing a diet plan including low-fat, low-insoluble fiber
	Avoiding gastrointestinal irritants/stimulants and irritating disaccharides
Constipation	Development of a diet plan which increases insoluble fiber and fluid intake
	Promotion of physical activity
	Assessment of the need for pharmacological intervention
Anorexia	Eating smaller portions and more frequently
	Consumption of high-calorie snacks