Tube Feeding Improves Intestinal Absorption in Short Bowel Syndrome Patients

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.

Abbreviations used in this paper: ETF, exclusive tube feeding, LCT, long chain triglycerides, MCT, medium chain triglycerides, OCEF, oral combined with enteral feeding, OF, oral feeding, SBS, short bowel syndrome, TF, tube feeding