Possible eating disorder - seeking advice to assist relative

amy19355

Am providing housing and assistance for my brother (59 yo) and seeking input to accompany the doctor care he is receiving for a variety of things. My questions come from an imagined scenario that has my brother willing to let me feed him when and what I choose, in an effort to help correct the GI ailments that plague him and elude his doctors.

Sometimes I am able to penetrate and nudge him in the right direction where he needs a nudge.

Background:
He’ll tell anyone who asks that he is allergic to food, and the way he reacts to anything he eats, it’s not a bad description. He’s pretty much in avoidance mode, and eats because he’s faint with hunger. Then he’s in distress for 3 days. And it’s a vicious circle. We just had a round at the ER and 3 days in for observation. Morphine cuts the pain, nothing makes the food go through the way it does for normal people.

He’s got a peptic ulcer that cannot be treated until he finishes another 3 month course of meds for a different ailment. No unreasonably limiting diet restrictions (no nuts, no alcohol, eat balanced) and stop smoking if you can.

Questions on my mind; looking for input:
If I could get him to eat something every hour, what small amount of which macro or combination of macros , would provide the maximum benefits with the least GI-distressful risk?

Along with that, is there any information on a reasonable time for restoring someone’s caloric intake upwards to its minimum? Are there risks to too much too soon?

How does one determine the life span of someone seemingly staying alive on 2500-3000 calories a week?

Meanwhile:
I have the VA as a resource and their mental health services are nearing the top of my ‘better call’ list.
For the next few months, at least maybe I can do something even a little useful with ideas from the nutrition -nerds in the room.

Thanks in advance.

apullum

I agree with you that getting mental health help for him is a good idea. It sounds like he has both physical and mental ailments that need professional care.

I would be hesitant to provide advice on what he should eat because we don't know what's causing the GI distress. I would be most concerned with just getting him the minimum number of calories, then concerned with protein and micronutrients. 1500 calories per day is the minimum recommended for men, but nearly all men would lose weight at that intake, and so he almost certainly would benefit from more than 1500 if he can eat that much.

Does he have problems when he eats foods that he has not been advised to avoid? Have you or he noticed any patterns of what foods do or do not cause problems? If you don't already, try keeping a food diary so you know which foods he can tolerate. Is he able to supplement with Ensure or similar meal replacements if he can't keep very much down? Has his doctor recommended a multivitamin or other supplement?

I would honestly feed him anything that he will eat and that is safe for his medical conditions. If that's a big slice of cake, then I'd feed him a big slice of cake...at least it will help him keep his strength up.

May I also recommend that you check out options for mental and emotional support for yourself? You sound like you're going through a very difficult time, so please be sure to take care of your own needs as well.

lorrpb

There is a National eating disorders help line I’ve seen mentioned here before. I suggest trying that it VA resources. This sounds like a far more complicated situation than anyone on here can give concrete useful advice.

rheddmobile

I was going to suggest Ensure, if he can handle it. Really anything that he can keep down. But the main thing is that he needs a diagnosis! There may also be a mental disorder but honestly the sort of distress you describe would put anyone off food.

Maxxitt

I have been treating an ulcer and chronic gastritis. Kefir, bananas, hot cereals like oatmeal and bulgar, rice, beans like pinto beans, bread, and small amounts of lean meat all sit well. I have pain after fatty meals of any kind, bacon (turkey or pork - might be the "smoke" not just the fat), and sometimes I can eat spicy food and sometimes I can't. Also, I might have symptoms after a meal and not know what triggered them because I had a few different foods involved. I will tell you that pain from food is a big behavior modifier. I hope your brother gets a good diagnosis and a reasonable treatment plan.

peggy_polenta

its good to think abut the hazards of increasing his intake from near zero to norma. there is something called refeeding syndrome when reintroducing food to someone who has not been eating. google it for more info. can get pretty serious.

mortuseon_

See a doctor. EDs kill

amy19355

mortuseon_ wrote: »

See a doctor. EDs kill

If only it were that simple.

Ever heard the one about the horse, and the water he won’t drink?

amy19355

dancingonstarz wrote: »

Have his doctors looked at gall stones or other gall bladder dysfunction as a contributing factor?

I don’t think so! Thanks for offering that idea ; it’s easy enough to ask the primary if it would have been an included blood test from last months round of labs.

Thanks!