Background: post-operative patients often experience gastrointestinal intolerance and altered sensory perception, including hyperosmia—an exaggerated sensitivity to smell that can significantly impact dietary intake. Hyperosmia heightens aversion to food odors, frequently resulting in reduced appetite, nausea, and poor tolerance to standard oral nutrition supplements (ONS). Tailored nutritional strategies that minimize sensory triggers are therefore essential to maintain adequate nutrient intake and support recovery.
Materials and Methods: A 54-year-old female with a history of intestinal obstruction, Hirschsprung’s disease, and previous abdominal surgeries underwent Hartmann’s reversal. Nutrition care was delivered from POD 3 to POD 8, with daily monitoring of oral intake, symptoms, ONS tolerance, and progression of diet. Hyperosmia contributed to intolerance to polymeric ONS. A transition to Pentasure Whey Max (100% whey isolate) was implemented based on sensory tolerance, protein requirements (1.2 g/kg/day), and energy targets (30 kcal/kg/day).
Results: The patient initially tolerated only liquids and polymeric ONS poorly, developing nausea and vomiting by POD 5. Switching to 100% whey isolate led to rapid improvement in tolerance within 24 hours. Protein intake increased from 28 g on POD 3 to 63 g/day by discharge (POD 8). Calorie intake progressively improved from 231 kcal/day to 1600 kcal/day. Whey isolate’s neutral taste minimized odor-triggered intolerance associated with hyperosmia, enabling consistent intake even during fluid restriction. Soft diet was fully tolerated by POD 7.
Conclusion: 100% whey isolate is an effective nutritional strategy for post-surgical patients with hyperosmia and feeding intolerance. Its neutral sensory profile, high digestibility, and flexibility in administration support adequate protein intake and enhance recovery. The case reinforces the importance of choosing ONS that align with sensory sensitivities in post-operative nutrition care.