Use of Oligomeric Formulas in Malabsorption: A Delphi Study and Consensus.

Area of Science:

• Gastroenterology
• Clinical Nutrition
• Medical Consensus

Background:

• Malabsorption syndrome presents with chronic diarrhea, abdominal distension, and malnutrition, complicating diagnosis and treatment.
• Oligomeric enteral formulas aid absorption in compromised bowel function but lack standardized protocols.
• Lack of uniform guidelines hinders effective implementation of these specialized formulas.

Purpose of the Study:

• Establish a multidisciplinary consensus on using oligomeric formulas for malabsorption.
• Develop standardized protocols for nutritional assessment and treatment in malabsorption.
• Utilize Delphi methodology to gather expert opinions on oligomeric formula use.

Main Methods:

• Conducted a Delphi study with 156 specialists across endocrinology, gastroenterology, oncology, and internal medicine.
• Administered two rounds of structured surveys on clinical practices and formula use.
• Analyzed data using descriptive statistics and non-parametric tests, defining consensus criteria (Median ≥7, IQR ≤3).

Main Results:

• Widespread support for malnutrition screening (79%), but only 38% have specific protocols.
• Abdominal distension, pain, and diarrhea predict intolerance to polymeric formulas, favoring oligomeric formulas.
• Consensus reached on the effectiveness of transitioning from oligomeric to polymeric formulas post-symptom stabilization.

Conclusions:

• Reinforces the need for specific clinical protocols in malabsorption nutritional management.
• Highlights the importance of initial oligomeric enteral formula use for severe symptoms.
• Emphasizes controlled transition to polymeric enteral formulas after symptom stabilization.