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Parenteral nutrition is associated with intestinal morphologic and functional changes in humans
A L Buchman1, A A Moukarzel, S Bhuta
1Division of Gastroenterology, Baylor College of Medicine, Houston, Texas 77030, USA.
JPEN. Journal of Parenteral and Enteral Nutrition
|November 1, 1995
Summary
Total parenteral nutrition (TPN) in humans causes minor intestinal villus atrophy and increased permeability. Enteral nutrition helps restore intestinal structure and function, with supplemented formulas showing potential benefits.
Area of Science:
- Gastroenterology
- Nutritional Science
- Human Physiology
Background:
- Animal studies show intestinal villus atrophy with TPN.
- Human intestinal changes during TPN are less understood.
- TPN as sole nutrition can impact gut morphology.
Purpose of the Study:
- To investigate intestinal morphologic and functional changes in humans receiving TPN.
- To assess the impact of enteral refeeding on TPN-induced changes.
- To compare standard vs. supplemented enteral formulas.
Main Methods:
- Eight healthy volunteers received 14 days of TPN.
- Enteral refeeding with standard or supplemented formula followed.
- Jejunal biopsies, mucosal analysis, and permeability tests were performed.
Main Results:
- TPN reduced mucosal thickness and villus height; crypt depth was unaffected.
- Intestinal permeability increased with TPN, indicated by lactulose-mannitol ratio.
- Enteral refeeding restored mucosal thickness; supplemented formula showed potential benefits.
Conclusions:
- TPN causes subtle intestinal changes in humans, unlike in animal models.
- Increased intestinal permeability may result from mucosal changes during TPN.
- Enteral nutrition is crucial for gut recovery post-TPN; supplemented formulas may offer advantages.