Managing Appetite Loss After Head Injury: Insights and Recommendations

Intracranial hemorrhage after a car accident?

Hello Dr.
Jiang, my husband was involved in a car accident on February 7.
After the emergency room visit, a CT scan revealed intracranial hemorrhage.
Fortunately, the amount was small and it stopped bleeding shortly after the accident, so he was observed in the ICU for four days before being transferred to a general ward.
On February 12, we performed surgery for fractures and a bladder rupture, and he has been hospitalized until now, February 23.
Thankfully, the surgeries went very well.
He has not experienced any symptoms of dizziness or nausea, and his recovery from the fracture surgery is good; he is able to walk independently.
Due to the bladder surgery, the nurses have been administering antibiotics daily (it is now the 12th day) and providing IV fluids.
However, the only issue is that my husband’s appetite has not improved; he only eats about 100 grams before saying he is full, and he has lost interest in foods he used to enjoy.
Currently, he is relying on Ensure to meet his daily nutritional needs.

I would like to ask:
1.
Is the issue of loss of appetite related to the brain contusion or the antibiotics?
2.
How can we increase his appetite?
3.
How long do drowsiness and loss of appetite typically last?
4.
If he is to drink Ensure, do you have any recommended types?
Thank you, doctor!

CC, 30~39 year old female. Ask Date: 2021/02/23

Dr. Jiang Junyi reply Neurology

Hello,
1.
Is the issue of loss of appetite related to a traumatic brain injury or antibiotics? It depends on the location of your husband's brain injury.
Generally, traumatic brain injuries from car accidents often affect the frontal lobe, which can lead to changes in executive function and personality.
2.
How can appetite be increased? It is recommended to take probiotics when using antibiotics to help maintain the balance of beneficial bacteria in the gut.
3.
How long do drowsiness and loss of appetite typically last? For brain injuries, the first six months are considered the golden period for rehabilitation, and it is advisable to implement a comprehensive rehabilitation plan.
4.
If he is currently considering drinking Ensure, are there any recommended types? It is suggested to discuss with a nutritionist to adjust based on his health condition.
I recommend consulting with a rehabilitation specialist or your attending physician regarding treatment.
Wishing you good health and peace.
Dr.
Jiang Junyi, Department of Neurology, Taoyuan Hospital.

Reply Date: 2021/02/23

More Info

Managing appetite loss after a head injury can be a complex issue, especially when there are multiple factors at play, such as trauma, surgery, and medication. In your husband's case, the combination of a head injury, subsequent surgeries, and the administration of antibiotics can all contribute to changes in appetite and overall well-being.

1. Connection Between Appetite Loss and Head Injury: Appetite loss can indeed be related to a head injury. The brain plays a crucial role in regulating hunger and satiety, and any trauma to the brain can disrupt these signals. In your husband's case, the intracranial hemorrhage and the subsequent surgeries may have affected his neurological function, leading to decreased appetite. Additionally, the stress of hospitalization and recovery can also impact appetite.
2. Impact of Antibiotics: Antibiotics can have side effects that may contribute to appetite loss. Common side effects include gastrointestinal disturbances such as nausea, diarrhea, and changes in taste, which can make food less appealing. If your husband is experiencing any of these side effects, it could explain his reduced interest in food.

3. Strategies to Increase Appetite: There are several strategies you can try to help stimulate your husband's appetite:
- Small, Frequent Meals: Instead of three large meals, offer smaller, more frequent meals throughout the day. This can make eating feel less overwhelming.

- Appealing Presentation: Make meals visually appealing. Sometimes, the presentation can entice someone to eat more.

- Favorite Foods: Encourage him to eat foods he previously enjoyed, even if they are not as appealing to him right now. Sometimes, familiarity can help.

- Nutrient-Dense Snacks: Offer nutrient-dense snacks that are easy to consume, such as smoothies, yogurt, or protein bars.

- Hydration: Ensure he stays hydrated, as dehydration can also suppress appetite. Sometimes, flavored drinks or broths can be more appealing than plain water.

- Consult a Dietitian: If appetite loss persists, consider consulting a registered dietitian who can provide tailored advice and meal plans to meet his nutritional needs.

4. Duration of Symptoms: The duration of appetite loss and fatigue (hypersomnia) can vary significantly from person to person. In many cases, these symptoms may improve as the individual recovers from the initial trauma and adjusts to any medications. It is not uncommon for appetite to take several weeks to return to normal after a significant injury or surgery. Monitoring his progress and maintaining open communication with his healthcare team is essential.

5. Recommended Nutritional Supplements: If your husband is relying on nutritional supplements like Ensure or similar products, you might consider different formulations based on his needs. For example, Ensure Plus provides extra calories and protein, which can be beneficial for someone recovering from surgery. If he has specific dietary restrictions or preferences, there are also plant-based or high-protein options available. Always consult with his healthcare provider before making changes to his diet or introducing new supplements.

In conclusion, while appetite loss after a head injury can be concerning, it is often a temporary issue that can be managed with the right strategies. Keep monitoring his condition, and do not hesitate to reach out to his healthcare team for further support and guidance.

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