(P08-002-23) Use of Betaine HCl With Pepsin in Esophageal Cancer Patient: A Case Report

Objectives:

Introduction: Patients with esophageal cancer typically undergo esophagectomy and/or chemotherapy as part of their treatment. Chemotherapy often induces a host of gastrointestinal side effects, the mechanisms of which are unclear. Likewise, esophagectomy results in significant anatomical changes to the GI tract including the vagus nerve, which regulates gastric motility. These alterations frequently result in a host of GI issues such as nausea, fatigue, weight loss and dumping syndrome which diminishes the patient’s quality of life.

Methods:

Case Description: One 76-year-old male experienced the GI problems listed above for months following esophagectomy and with no recommended nutrition interventions from his medical team. The principal investigator (PI), an outpatient Registered Dietitian Nutritionist (RDN), introduced a digestive support supplement, Betaine HCl with Pepsin (BHClP), developed by Thorne®. The patient ingested 1 capsule containing 500mg Betaine Hydrochloride and 23.5mg Pepsin prior to protein-containing meals and reported a substantial decrease in GI symptoms while eating a regular diet with no limitations. He gained necessary weight and energy for daily activities. After a few months, the patient discontinued BHClP, resulting in a loss of 7.5% of his body weight, while the dumping syndrome and GI symptoms returned. When the patient reinitiated the supplement, his weight returned and GI symptoms dissipated.

Results:

Discussion: With structural and functional changes to the GI tract, dumping syndrome and regulation of gastric motility became new complications for this patient postoperatively. The BHClP digestive support supplement provided therapeutic benefit in nutrient metabolism, thereby getting the most out of the patient’s oral intake and preventing further complications and malnutrition.

Conclusions:

Conclusions: A BHCIP supplement intervention recommended by an RDN was effective in improving the quality of life for a cancer patient who underwent esophagectomy. Additional research is needed to fully realize the mechanisms and clinical use of BHCIP in this patient group. These findings suggest that active involvement with an outpatient RDN could improve the quality of life for this vulnerable population while also reducing the risk of malnutrition and post-op complications.

Funding Sources: None