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 Spinal cord injury affects all aspects of physical health, and nutrition is no exception. In the days and weeks following injury, nutritional needs change. In the acute phase, caloric needs are higher as the body attempts to help heal itself and burns more calories than normal. This hyper state of metabolism often leads to an initial weight loss. Additionally, due to the severity of their injury, many patients have a poor appetite in the early days following injury.
Depending on the type of injury, some patients may have difficulty swallowing. These patients may need to be fed via a nasogastric tube (a tube that is inserted through the nose and into the stomach) until swallowing ability improves. If swallowing issues continue long-term, patients may have a permanent feeding tube inserted into their stomach through the abdominal wall.
Liquid nutrition can be safely given this way, permanently if necessary.
In general, nutritional needs of a SCI patient should be assessed soon after injury, and a plan should be implemented to meet the patient’s nutritional needs for healing. Addressing this need early may help to prevent complications (such as pressure ulcers and infection) from developing.
Long-term Nutritional Needs
As patients with SCI move out of the acute phase of their injuries, their caloric and nutritional needs also change. There are three areas that are especially important for patients with SCI to address: bowel regulation, skin care, and weight management. Bowel issues, especially constipation, can occur due to the patient’s lack of mobility, which is needed to stimulate the bowel. Pressure ulcers can be of continuous concern, also due to immobility and poor circulation. Patients with SCI often have difficulty maintaining their weight due to lack of exercise and a decrease in muscle mass. Eating a well-balanced diet, along with exercise, can help address these problems. The following are some guidelines that patients with SCI can keep in mind for meal planning.
Calcium Patients who are confined to a wheelchair are at increased risk of developing osteoporosis. Calcium can help prevent osteoporosis and improve muscle and nerve functioning. Calcium is also necessary for blood clotting.
Fiber-Fiber can be invaluable in maintaining healthy bowel function. As patients who have SCI are prone to constipation due to immobility, fiber should be added to the diet. Fiber can be found in vegetables, fruits, and starches.
Protein-Protein is essential for healthy muscles and skin. It also contributes to a healthy immune system. Protein can be found in meat, beans, eggs, fish, and many other foods. Patients with a SCI should avoid diets that are high in protein and low in carbohydrates, as these may contribute to the development of kidney problems.
Salt-Sodium regulates fluid balance, contraction of muscles, and conduction of nerve impulses. Too much sodium can cause water retention, swelling, heart and kidney disease, and stroke.
Water-Water helps regulate body temperature and digestion of food. It also helps to prevent urinary tract infections and kidney and bladder stones. Water is key in bowel management. Patients with a SCI should strive to drink at least 8 glasses of water a day.
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