Tube Feeding Improves Intestinal Absorption in Short Bowel Syndrome Patients
Received 19 December 2007; accepted 23 October 2008. published online 13 November 2008.
Background & Aims
Tube feeding, recommended for patients with short bowel syndrome in only the postoperative period, has not been compared with oral feeding for absorption. We studied whether tube feeding increased absorption in patients with short bowel syndrome following the postoperative period.
Methods
A randomized crossover study compared absorption between isocaloric tube feeding and oral feeding in 15 short bowel syndrome patients more than 3 months after short bowel constitution. An oral feeding period combined with enriched (1000 kcal • day−1) tube feeding was also tested. We measured the net intestinal absorption rates of proteins, lipids, and total calories using elemental nitrogen, Van de Kamer, and bomb calorimetry methods, respectively.
Results
Tube feeding increased the mean (±SD) percent absorption (P < .001) of proteins (72% ± 13% vs 57% ± 18%), lipids (69% ± 25% vs 41% ± 27%), and energy (82% ± 12% vs 65% ± 16%) compared with oral feeding. In the group given the combined feedings (n = 9), the total enteral intake and net percent absorption increased (P < .001) for proteins (67% ± 10%), lipids (59% ± 19%), and total energy (75% ± 8%) compared with oral feeding. Absorption (kcal • day−1) was greater (P < .001) with tube (2225 ± 457) and combined feedings (2323 ± 491) than with oral feeding (1638 ± 458).
Conclusions
In patients with short bowel syndrome, continuous tube feeding (exclusively or in conjunction with oral feeding) following the postoperative period significantly increased net absorption of lipids, proteins, and energy compared with oral feeding.
⁎Gastroenterology and Nutrition Support, Center for Intestinal Failure, Adult Approved Home Parenteral Nutrition Center of Paris-Ile de France, Pôle des Maladies de l'Appareil Digestif (PMAD), AP-HP, Beaujon Hospital, Clichy, France
‡Department of Digestive Diseases, AP-HP, Lariboisière Hospital, Paris
§Coprologie fonctionnelle, Pitié Salpétrière Hospital, Paris, France
Reprint requests Address requests for reprints to: Francisca Joly, MD, Hôpital Beaujon-Service de Gastro-entérologie et Assistance Nutritive, 100 bd Général Leclerc-Clichy, France
Conflicts of interest The authors disclose no conflicts.
ABSTRACT