Interní Med. 2012; 14(4): 152-156

Enteral nutrition in clinical practice

MUDr.Milan Dastych

Interní gastroenterologická klinika FN Brno

Enteral nutrition (EN) is defined as delivery of balanced solutions by sipping or tube into the gastrointestinal tract. EN is indicated

when the patient is unable to eat for any reason and has a functional gastrointestinal tract. Contraindications for administering EN are:

acute abdomen, gastrointestinal bleeding, ileus, high-output intestinal fistulae, and complete loss of bowel function (mucositis, severe

enteritis and colitis). Currently, a number of enteral formulas are available: with an energy density of 0.6–2.0 kcal/mL, with or without

fibre, with increased protein content, enriched with omega-3 fatty acids, glutamine, and arginine. Some are organ-specific intended for

patients with renal and hepatic failure. EN can be administered by using a tube or by sipping. The following can be used for entry into

the gastrointestinal tract: nasogastric tube, PEG, surgical gastrostomy, nasojejunal tube, percutaneous gastrojejunostomy, and surgical

jejunostomy. Total enteral nutrition must be initiated slowly (with a full dose achieved within 4–5 days); when initiated more rapidly,

it may often be poorly tolerated. Complications associated with administering EN include decubital ulcers at the site of tube pressure,

parastomal infections, sinusitides, diarrhoea, and aspiration in the case of an inappropriate method of EN administration. Nutritional

and metabolic complications are rarely encountered in EN (overfeeding syndrome, refeeding syndrome, enteral nutrition syndrome).

Monitoring of EN involves regular observation of weight, evaluation of dose tolerance of the selected EN, and performance of biochemical

tests according to the patient‘s clinical condition, usually at weekly intervals. Due to the absence of pharmacological adverse effects

and a simple method of delivery, EN can be administered safely in the home setting. Enteral nutrition is an effective tool in dealing

with malnutrition in both inpatient and outpatient care.

Keywords: enteral nutrition, malnutrition, nasojejunal tube, PEG

Published: April 23, 2012  Show citation