Use of enteral nutrition for stress ulcer prophylaxis

The objective of this review article was to review the controversies involving the use of enteral nutrition support for stress ulcer prophylaxis and formulate recommendations. Animal and human data from prospective studies, retrospective studies, and case series were evaluated for the effects of enteral nutrition on gastric pH, intramucosal pH, gastrointestinal blood blow, development of macroscopic mucosal erosions, and hemorrhage. Definitive recommendations regarding the role of enteral nutrition for stress ulcer prophylaxis are not possible because of the lack of prospective, randomized studies. Therefore, the use of enteral nutrition as the only therapeutic agent for stress ulcer prophylaxis should be discouraged until definitive data are available. Initiation and discontinuation of pharmacologic stress ulcer prophylaxis should be independent of enteral nutrition.