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[Enteral nutrition: past and future]
S Bengmark1, J J Ortiz de Urbina
1Departamento de Hepatología y Cirugía, Facultad de Medicina, Universidad de Londres, RU. sbengmark@onetel.net.uk
Nutricion Hospitalaria
|March 31, 2004
Summary
Early enteral nutrition, especially when including fiber and probiotics, can significantly enhance the immune system and reduce complications following major surgery. This approach is crucial for patient recovery and preventing post-operative issues.
Area of Science:
- Immunonutrition
- Gastroenterology
- Surgical Nutrition
Context:
- Perioperative nutrition has evolved from basic caloric support to immune system modulation.
- Despite medical advances, perioperative morbidity and infection rates remain significant challenges, particularly in older adults and immunocompromised individuals.
- The gastrointestinal tract, housing 80% of the immune system, is a key target for nutritional interventions.
Purpose:
- To highlight the historical evolution and modern understanding of perioperative nutrition.
- To emphasize the role of early enteral nutrition in boosting immune function and reducing surgical complications.
- To underscore the importance of gut-specific nutrition, including fiber and probiotics, for enhancing immune resistance.
Summary:
- Early enteral nutrition, initiated preoperatively and continued postoperatively, is a powerful tool for preventing surgical complications.
- Tube feeding is often necessary due to the risk of postoperative gastric paralysis.
- Optimal perioperative nutrition involves providing substrates that support gut health, including fiber for colonic fermentation and probiotics.
Impact:
- Early enteral feeding strategies can improve patient outcomes by increasing resistance to infections and other complications.
- Targeting the gastrointestinal tract through nutrition offers a promising avenue for enhancing immune defense in surgical patients.
- Continuous nutritional support, encompassing the pre-operative, intra-operative, and post-operative periods, is vital for mitigating surgical risks.