Enteral nutrition gastrointestinal complications

Gastrointestinal complications are the most common complications of enteral nutrition (EN), limiting the amount of feeding that patients receive. 

Detsky AS, Baker JP, O Rourke K, et al. Predicting nutrition-associated complications for residents undergoing gastrointestinal surgery. JPEN J Parenter Enteral Nutr 1987 11 440 46. 

The gastrointestinal (Gl) tract is the optimal route for providing nutrients unless obstruction, severe pancreatitis, or other Gl complications are present (see Fig. 136-1). Other considerations that may have an impact on determination of an appropriate route for nutrition support include expected duration of nutrition therapy and risk of aspiration. Patients who have nonfunctional Gl tracts or are otherwise not candidates for enteral nutrition (EN) may benefit from PN. Use of the intravenous route for nutrition support is also commonly referred to as total parenteral nutrition (TPN) or hyperalimentation. Routine monitoring is necessary to ensure that the nutrition regimen is suitable for a given patient as his or her clinical condition changes and to minimize or treat complications early. 

The gastrointestinal (Gl) tract defends the host from toxins and antigens by both immunologic and nonimmunologic mechanisms, collectively referred to as the gut barrier function. Whenever possible, enteral nutrition (EN) is preferred over parenteral nutrition (PN) because it is as effective, may reduce metabolic and infectious complications, and is less expensive. 

---