Problems of Nutritional and Metabolic Therapy of Patients with Intestinal Fistulas

Intestinal fistulas remain a multidisciplinary, often life-threatening problem of clinical medicine. Such patients in the process of their conservative and surgical stages of treatment remain in a state of systemic metabolic dysfunction for a long time, which is usually accompanied by phenomena of trophological insufficiency of varying severity. In this regard, one of the most important areas of treatment for this category of patients is nutritional-metabolic therapy (NMT), aimed at minimizing the consequences, and, if possible, stopping the catabolic orientation of metabolism, which will help stabilize the trophological status of patients and improve the results of their treatment. NMT of patients with intestinal fistulas still remains a very complex and insufficiently resolved problem that requires further study. This article discusses the features and controversial issues of NMT for this category of patients, as well as a rational choice of nutritional accesses and optimal energy and protein supply when implementing clinical nutrition depending on the anatomical affiliation of the fistula and the degree of its production.