Use of Elemental Diet During the Adaptive Stage of Short Gut Syndrome

Abstract

An elemental diet was used during the adaptive phase of the short gut syndrome in 8 patients. The diet was well tolerated by the patients, and positive nitrogen balance was achieved. There was an average weight gain of 3.3 kg per month for the group. Adaptation in 4 patients was sufficient to tolerate normal food. One patient underwent major surgery which he withstood well, and eventually had intestinal continuity restored. Three patients died—2 from their disease and 1 from aspiration. The latter patient demonstrates the importance of radiographic verification of nasogastric tube position prior to diet infusion. Provided that care is taken with tube position, no serious complications with this technique are encountered. Elemental diet is a useful addition to the nutritional armamentarium in the treatment of short gut syndrome, if sufficient absorptive surface is left. In extremely short bowels, even a predigested elemental diet may not be absorbable initially, but adaptation may provide sufficient absorptive surface to allow eventual chronic use of elemental diet in preference to permanent intravenous hyperalimentation.