Nutrition

The use of enteral and parenteral nutritional support is increasing at a ra pid pace. The use of nutritional therapy in the medical patient poses multi ple challenging problems. The managing physician must be able to assess the patient for evidence of malnutrition, be able to select the proper method by which nutrition is delivered, and know how to identify and manage the co mplications associated with the provision of enteral and parenteral nutriti on. In addition, the medical patient is a heterogeneous patient, and patien ts with diseases such as inflammatory bowel disease, pancreatitis, liver fa ilures and renal failure as well as critically ill or cancer patients all h ave unique nutritional problems that merit specific attention and considera tion. As nutrition advances as a science, the clinician must be aware of th e treatment capabilities of nutritional therapy and the limitations and eth ical issues associated with the use of artificial nutrition.