A 35-year-old man, who had spent 10 out of 18 months in hospital, has required repeated courses of intravenous nutrition (IVN) because of nutritional failure due to severe inflammatory bowel disease. He has been maintained on a nocturnal pump-fed liquid diet supplementing his day-time oral diet jar five months, four of which have been at home. The cost of such therapy is less than with an elemental diet and there are other advantages. This regime has been shown to be nutritionally adequate. The need to assess other cheaper liquid diets in patients with intestinal failure is recognised.
Get full access to this article
View all access options for this article.
References
1.
ReillyJRyanJAStroleWFischerJE. Hyperalimentation in inflammatory bowel disease. Am J Surg1976; 131: 192–200.
2.
DriscollRHRosenbergIH. Total parenteral nutrition in inflammatory bowel disease. Med Clin North Am1978; 62: 185–201.
3.
GreenbergGRHaberGBJeejeebhoyKN. Total parenteral nutrition (TPN) and bowel rest in the management of Crohn's disease. Gut1976; 17: A.828.
4.
MacFadyenBVDudrickSJ. In RomieuGSolassolCJoyeuxH eds: International Congress on Parenteral Nutrition, France, University of Montpelier1974; 559–562.
5.
EisenbergHWTurnbullRBWeakleyFL. Hyperalimentation as preparation for surgery in transmural colitis (Crohn's disease). Dis Col Rect1974; 17: 469–475.
6.
ScheflanMGalliSJPerottoJFischerJE. Intestinal adaptation after extensive resection of the small intestine and prolonged administration of parenteral nutrition. Surg Gynecol Obstet1976; 143: 757–762.
7.
WeserE. The management of patients after small bowel resection. Gastroenterology1976; 71: 146–150.
8.
RaultRMJScribnerBH. Treatment of Crohn's disease with home parenteral nutrition. Gastroenterology1977; 72: 1249–1252.
9.
JeejeebhoyKNLangerBTsallasGChuRCKuksisAAndersonGH. Total parenteral nutrition at home: studies in patients surviving four months to five years. Gastroenterology1976; 71: 843–953.
10.
LadefogedKJarnumS. Long term parenteral nutrition. Br Med J1978; 2: 262–266.
11.
StephensRVRandallHT. Use of concentrated, balanced, liquid elemental diet for nutritional management of catabolic states. Ann Surg1969; 170: 642–667.
12.
VoitkAJEchaveVFellerJHBrownRAGurdFN. Experience with elemental diet in the treatment of inflammatory bowel disease. Arch Surg1973; 107: 329–333.
13.
GoodeAHawkinsTFeggetterJGJohnstonIDA. Use of an elemental diet for long term nutritional support in Crohn's disease. Lancet1976; 1: 122–124.
14.
AxelssonCJarnumS. Elemental diet in gastrointestinal diseases: experience from a case material of 59 patients. Infusionstherapie1977; 4: 313–318.
15.
RocchioMAChaCJMHaasKFRandallHT. Use of chemically defined diets in the management of patients with acute inflammatory bowel disease. Am J Surg1974; 127: 469–475.
16.
RussellRIHallMJ. Elemental diet therapy in the management of complicated Crohn's disease. Scott Med J1979; 24: 291–295.
17.
NelsonLMCarmichaelHARussellRIAthertonST. Use of an elemental diet (Vivonex) in the management of bile acid-induced diarrhoea. Gut1977; 18: 792–794.
18.
WoolfsonAMJSaourJNRickettsCRPollardBJHardySMAllisonSP. Prolonged nasogastric feeding in critically ill and surgical patients. Postgrad. Med J1976; 52: 678–692.
HoffmeisterJADobbieRP. Continuous control pump-tube feeding of the malnourished patient with Isocal. Am. Surgeon1977; 43 (1): 6–11.
21.
MastertonJPDudleyHAISheilaMacRae. Design of tube feeds for surgical patients. Br Med J1963; 2: 909–913.
22.
GlotzerDJ. Space diets. Gastroenterology1971; 61 (3): 405–406.
23.
RussellRI. Intravenous nutrition and elemental diets in gastrointestinal disease. In Scientific Foundations of Gastroenterology, eds SircusWSmithAN. London: Heinemann1980: 130–142.