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Nutritional support in gastrointestinal disease

G M Levine

    The Surgical Clinics of North America
    |June 1, 1981
    PubMed
    Summary

    Nutritional support can heal many gastrointestinal fistulas. Enteral nutrition is preferred for upper fistulas via distal infusion, but parenteral nutrition is used if drainage increases.

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    Area of Science:

    • Gastroenterology
    • Surgical Nutrition

    Background:

    • Gastrointestinal fistulas often require nutritional support for healing.
    • The etiology of the fistula (e.g., inflammatory bowel disease, malignancy) influences treatment.
    • Both enteral and parenteral nutrition are options for fistula management.

    Purpose of the Study:

    • To outline the principles of nutritional support for gastrointestinal fistulas.
    • To differentiate the selective use of enteral nutrition versus parenteral nutrition.
    • To provide guidance on the optimal method of nutritional therapy delivery.

    Main Methods:

    • Nutritional support strategies were reviewed.
    • Enteral nutrition delivery via distal infusion (tube or jejunostomy) was discussed for upper GI fistulas.
    • Enteral nutrition delivery into the proximal bowel was considered for ileal or colonic fistulas.

    Main Results:

    • Nutritional support can lead to spontaneous healing of many gastrointestinal fistulas.
    • Enteral nutrition is recommended for upper GI fistulas via distal infusion, avoiding increased fistula drainage.
    • If enteral feeding exacerbates drainage, parenteral nutrition should be initiated.
    • Enteral therapy for ileal or colonic fistulas requires adequate absorptive bowel length proximal to the fistula.

    Conclusions:

    • Nutritional support is a cornerstone in managing gastrointestinal fistulas.
    • Enteral nutrition is a viable and often preferred method, but requires careful administration.
    • Parenteral nutrition serves as an alternative when enteral routes are contraindicated or ineffective.

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