Example of regimen used at Guy’s and St Thomas Hospital, London
The Emergency Regimen (ER) is recommended if you become unwell e.g. nausea, vomiting, diarrhea, high temperature or any illness resulting in loss of appetite and inability to take your normal diet.
The emergency regimen of glucose polymer drinks should be commenced immediately if you become unwell e.g. nausea, vomiting, diarrhea, high temperature or any illness resulting in loss of appetite and inability to take your normal diet.
The ER is used to prevent the release phytanic acid from your body fat which can occur if your body is not getting adequate carbohydrates during illness. It is important to have the right amount of glucose to maintain your body metabolism, and prevent breaking down of your body’s alternative source of energy during this time.
At the first sign of feeling unwell and loss of appetite, take 200 ml glucose polymer drink (see recipes below). If you feel better within one to two hours, you may return to your normal diet.
If you continue to feel unwell, commence the full emergency regime as described below and contact the Adult Inherited Metabolic team.
If you are unable to tolerate the emergency regime, if you do not improve, or if you become increasingly unwell, go to your local Accident and Emergency (A&E) and ask the hospital healthcare team to contact the Adult Inherited Metabolic team.
The full emergency regime
Take the ER drinks every two hours day and night
If tolerated, continue all prescribed medicines
You should not use your ER for more than 2 days without your normal diet. If your symptoms persist and you are unable to tolerate your ER, contact your GP or go to your nearest Accident and Emergency (A&E). Inform your Inherited Metabolic team.
Continue with extra glucose polymer drinks during the day until the normal diet is resumed
Recipes for 20% emergency regimen drink
One of the following recipes will be recommended by your Dietitian. These can be made up using 200ml of water. Consume all 200mls of the ER drink every 2 hours day and night.
40g Maxijul Super Soluble, Polycal or Vitajoule powder
OR 1 sachet of S.O.S 20 (Vitaflo)
Alternative oral emergency drinks for adults
Ideally 200mls of the emergency drink (as per recipe above) must be taken every 2 hours when you are unwell. If you cannot take any of the ER drink or you don’t have access to them quickly, then you can start with an alternative drink such as the options given below. You will need to drink more than 200mls of the alternative drinks every 2 hours to get your carbohydrate needs.
Mountain Dew Citrus Burst (13g carbohydrates per 100ml) Take 300ml every 2 hours
Coca Cola (full sugar) (10.6g carbohydrates per 100ml) Take 380ml every 2 hours
Pepsi (full sugar) (11g carbohydrates per 100ml) Take 380ml every 2 hours
Fruit juice (eg apple juice) (at least 10g carbohydrates per 100ml) Take 400ml every 2 hours
Carbohydrate content of the drinks can change. Please regularly check the carbohydrate content per 100ml to ensure it still contains the above amount of carbohydrate.
Some of the above alternative drinks contain caffeine. Use of these for 24 hours during illness would be appropriate. When well, to consume in moderation.