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Other dietetic services

 

Home Enteral Feeding

All patients discharged with a PEG or PEJ from a hospital in Cornwall will be known to the Home Enteral Feeding Service and will be regularly reviewed.

Refer any patient who does not have regular contact  ( at least every 6mths ) with the home enteral feeding team or who has symptoms potentially related to their feed e.g.

·         unintentional weight loss

·         unintentional weight gain

·         nausea, vomiting, bloating 

·         persistent diarrhoea

For problems relating to the PEG tube or stoma contact the gastrostomy nurse on cornwallstrokeservice@nhs.net

 

Renal

All patients who are on dialysis are known and reviewed by the Renal Dietitians. Other patients with CKD 4/5  are referred by the  Renal Consultants/Renal Team.  Refer to the Renal Dietician if you have any dietary concerns with a renal patient under your care:

·         with CKD 4/5,

·         patient is on dialysis

 

Oncology

Most patients will already be known and referred to the dietitian via the Oncology Team and consultant but consider referral if:

·         The patient is losing weight or is at risk of malnutrition

·         Their swallow is effected by the disease or treatment

Good advice can be found on

http://www.macmillan.org.uk/information-and-support/coping/maintaining-a-healthy-lifestyle/healthy-eating/healthy-diet-benefit.html#13743

 

Gastroenterology

Patients may already be known to the dietitian via gastroenterology consultant but consider referral if :

·         The patient has newly diagnosed coeliac disease (and not already referred)

·         The patient has symptoms of irritable bowel syndrome that do not respond to first line advicehttps://www.bda.uk.com/foodfacts/IBSfoodfacts.pdf

·         The patient has a difficult to manage allergic response to foods that potentially results in exclusion of main food groups, nutritional deficiencies and/or weight loss

·         Decompensated liver disease with significant muscle loss.

·         Fatty liver linked with obesity

Learning Disabilities

 

Please refer to the dietitian working with the learning disability service using the referral form if: 

·         The patient has complex needs requiring input from a number of specialists within the learning disability service, eg Speech and language therapist, learning disability nurse .

·         The patient will struggle to access main stream services due to challenges with communication , behaviour etc.

·         The patients’ dietary needs are closely associated with their learning disability, eg limited food selection, weight loss associated with swallowing problems.

·         The patient’s family and/or care team need additional support and advice that cannot be delivered via a routine clinic appointment.   

Eating Disorders

 

Specialist dietitians can be accessed via the CAMHS and Adult Eating Disorders Services. 

 

<18 years- refer to the CAMHS Eating Disorders Service - a specialist dietitian will conduct a dietetic assessment as part the Eating Disorders Assessment.

 

>18 years - refer to the ICMHT who after initial assessment will refer to the Adult Eating Disorders Service. Once the person has been assessed and meets service criteria specialist dietetics will be offered as part of their treatment.  

 

Further information can be found here