What is Refeeding Syndrome

Refeeding syndrome is a group of problems that can develop when a person who has not been eating for some time begins to eat or get nutrition supplements. These problems can be life threatening.

What are the causes?

This condition is caused by chemical and fluid shifts that occur in the body when food or nutrients are rapidly reintroduced into the body.

What increases the risk?

The following factors may make you more likely to develop this condition:

• Not getting enough nutrients in your diet over time (being malnourished).
• Certain medical conditions, such as cancer, heart disease, liver disease, poorly controlled diabetes, chronic obstructive pulmonary disease (COPD), eating disorders, alcoholism, and conditions that interfere with normal swallowing.
• Medical conditions that make it difficult to absorb nutrients, such as inflammatory bowel diseases, cystic fibrosis, and chronic pancreatitis.
• Sudden, significant weight loss.
• Having had weight loss surgery (bariatric surgery).
• Being elderly.
• Long-term use of medicines such as antacids or diuretics.

What are the signs or symptoms?

Symptoms of this condition include:

• Breathing problems.
• Heart problems, including abnormal heart rhythms.
• Low blood pressure (hypotension).
• Diarrhea.
• Muscle breakdown.
• Seizures.
• Coma.

How is this diagnosed?

This condition may be diagnosed based on your medical history, a physical exam, and blood tests.

How is this treated?

Treatment depends on the cause and severity of your condition. Treatment often requires hospitalization.

This condition is treated with nutritional supplements, which may include vitamins and electrolytes such as potassium, calcium, phosphate, and magnesium. Depending on your condition, the supplements may be given:

• By mouth.
• Through an IV (parenteral nutrition).
• Through a tube that goes into your stomach (feeding tube).

To prevent the condition from coming back, anyone who has this condition must feed at a very slow rate.

You may need monitoring and treatment for other conditions that develop. This may include:

• Blood and urine tests.
• Heart monitoring. This may include an electrocardiogram (ECG).
• Receiving fluids through an IV tube.

Follow these instructions at home:

• Follow instructions from your health care provider about nutrition. Do not change your diet without talking with your health care provider first.
• Take nutritional supplements only as told by your health care provider.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Monitor your food intake, weight, and other vital signs if your health care provider asks you to. Write down your observations.
• Keep all follow-up visits as told by your health care provider. This is important.

Get help right away if you:

• Have symptoms that return after treatment.
• Develop new symptoms.
• Continue to have symptoms.
• Have an increased heart rate.
• Are unable to eat or drink.
• Have a fever.
• Develop nausea or vomiting.
• Faint.
• Become disoriented or confused.

Summary

• Refeeding syndrome is a group of problems that can develop when a person who has not been eating for some time begins to eat or get nutrition supplements. These problems can be life threatening.
• This condition is caused by chemical and fluid shifts that occur in the body when food or nutrients are rapidly reintroduced into the body.
• You are more likely to develop this condition if you are not getting enough important nutrients over time, you have sudden weight loss, or you use medicines such as antacids and diuretics.
• This condition is treated with nutritional supplements. They may be given by mouth, through an IV, or through a tube that goes into the stomach.