Use of an elemental diet as a nutritionally complete "medical colostomy"

During the past 24 months I have used a defined formula diet (High Nitrogen Vivonex) as a nutritionally complete "medical colostomy" (NCMC) in 16 patients. This diet, via continual gastric drip, provided an average of 2,238 kcal/day and 92.4 gm of protein per day. Separately or in combination, loperamide HCl, diphenoxylate HCl, or codeine was used to slow the bowel. No patient had a bowel movement within less than three days postoperatively and the mean between bowel movements was 5.6 days. Defined formula diet, used as an NCMC, can give 2.4 times more kcal than clear liquid and provides protein as well. NCMC is a safe, cost-effective way of preventing fecal contamination while providing adequate nutritional support for wound healing.