Route of Nutrition in Malabsorption

Several factors need to be considered when recommending whether oral, enteral, or parenteral nutrition should be used to provide nutrition to the patient with malabsorption, including etiology of malabsorption, severity of gastrointestinal disease, and underlying nutritional and medical condition. Oral nutrition using modified diets as noted previously is the most customary and desirable by physician and patient alike. In cases of mild lactose malabsorption, modification of a regular, healthy diet to avoid foods high in lactose should be sufficient. In cases in which widespread gastrointestinal disease is leading to severe malabsorption, enteral or 'tube' feeding is helpful for two main reasons: (i) Use of proprietary formulas specially designed for malabsorption is often indicated, and these formulas may be unpalatable, and (ii) enteral feedings, especially slow continuous 'drip' feedings, make efficient use of nutrient transport kinetics, thereby maximizing residual gastrointestinal absorptive function. In severe cases of malabsorption in which tube feedings are unable to achieve adequate nutritional intake, parenteral nutrition may be indicated.

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