International Journal For Multidisciplinary Research

E-ISSN: 2582-2160   •   Impact Factor: 9.24

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Nutritional and Multidisciplinary Management in Guillain–Barré Syndrome: A Case Study

Author(s) Ms. Swetha Sri Douluri, Ms. Haritha Shyam Bathina
Country India
Abstract Guillain–Barré Syndrome (GBS) is a rapidly progressive neurological disorder characterized by acute muscle weakness resulting from immune-mediated damage to the peripheral nervous system.
A 44-year-old male patient was admitted with complaints of fever, left-sided weakness, and left upper limb weakness. Electrophysiological evaluation revealed findings suggestive of motor and demyelinating polyradiculoneuropathy involving both upper and lower limbs. Due to progressive respiratory distress, the patient required mechanical ventilation, and enteral nutrition was initiated on Day 2 of hospitalization.
The treatment plan included immunoglobulin therapy and therapeutic plasma exchange, along with physiotherapy sessions conducted every six hours to support neuromuscular recovery.
A detailed Subjective Global Assessment (SGA) was performed on admission, categorizing the patient as well-nourished. Nutritional status was subsequently reassessed on a monthly basis. Enteral nutrition providing approximately 2520 kcal and 126 g of protein per day was initiated. The patient tolerated enteral feeds for the first 10 days but later developed loose stools. A semi-elemental diet was introduced; however, this was not tolerated beyond Day 14. Consequently, total parenteral nutrition (TPN) along with clear liquids and soluble fiber was initiated.
Enteral nutrition was reintroduced on Day 24 to reassess tolerance but remained poorly tolerated. By Day 27, kitchen-based feeds and easily digestible foods were gradually introduced and tolerated well. Despite these efforts, the patient experienced significant weight loss of approximately 20 kg over the first two months due to prolonged feeding intolerance.
From the third month onward, a specialized pre-digested elemental formula designed for patients with severe gastrointestinal sensitivity was prescribed. This formula was well tolerated, and the patient received approximately 50% of daily caloric intake from the formula, with the remaining calories provided through TPN and oral kitchen-based feeds for the next three months. As adequate caloric intake was achieved, TPN was gradually tapered and discontinued.
From the fourth month, oral semi-solid foods were progressively introduced to facilitate transition to solid feeding. By the sixth month, the patient was able to meet nutritional requirements through oral semi-solid meals supplemented with high-protein nutritional products, resulting in a weight gain of approximately 5 kg over six months.
After a seven-month hospital stay, the patient was discharged with a body weight of 69.6 kg. Follow-up evaluation in the eighth month showed further improvement, with the patient’s weight increasing to 72 kg.
Published In Volume 8, Issue 2, March-April 2026
Published On 2026-03-14
DOI https://doi.org/10.36948/ijfmr.2026.v08i02.70894
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