A randomised controlled crossover trial comparing a polymeric with a semi-elemental oral nutritional supplement on fluid and sodium status in patients with a jejunostomy
Background: Patients with a short bowel need to restrict oral fluid to reduce stoma/fistula output. Some patients require oral nutritional supplements (ONS) to meet nutritional requirements. There is limited research on ONS for patients with a short bowel. This study aimed to compare polymeric verse...
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Elsevier
2024-01-01
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| Series: | Intestinal Failure |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2950456224000022 |
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| author | Alison Culkin Beth Rye Jeremy MD Nightingale |
| author_facet | Alison Culkin Beth Rye Jeremy MD Nightingale |
| author_sort | Alison Culkin |
| collection | DOAJ |
| description | Background: Patients with a short bowel need to restrict oral fluid to reduce stoma/fistula output. Some patients require oral nutritional supplements (ONS) to meet nutritional requirements. There is limited research on ONS for patients with a short bowel. This study aimed to compare polymeric verses semi-elemental ONS on jejunal wet weight and sodium output. Materials and methods: Patients were included if they had < 200 cm of small bowel to a jejunostomy or an enterocutaneous fistula. Patients fasted from midnight then were randomly allocated to consume 200 ml of either Vital 1.5® or Ensure Plus® over 30 min. Jejunal output and urine were collected for 6 h during which patients remained nil by mouth. Jejunal and urine outputs were weighed, and samples sent for analysis. After a day washout, patients were swapped to the other ONS. Differences between the two study periods were assessed using multilevel regression. Results: Ten patients completed, 4 females: 6 males, mean age 59.2 years, mean small bowel length 95 cm. Jejunal wet weight (P < 0.001) and jejunal sodium (P = 0.003) were significantly higher on Vital 1.5® compared to Ensure Plus® with a mean difference of 0.1 kg and13mmol respectively. There was no difference in faecal sodium balance (P = 0.16), urine sodium (P = 0.38) or urine volume (P = 0.56). Conclusion: A semi-elemental ONS results in a greater jejunal wet weight loss compared to a polymeric one. The amount is small but the daily cumulative loss will be greater. |
| format | Article |
| id | doaj-art-71f05a194a1f45ebb2f29d6dc85c3363 |
| institution | DOAJ |
| issn | 2950-4562 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
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| series | Intestinal Failure |
| spelling | doaj-art-71f05a194a1f45ebb2f29d6dc85c33632025-08-20T02:51:40ZengElsevierIntestinal Failure2950-45622024-01-01110000210.1016/j.intf.2024.100002A randomised controlled crossover trial comparing a polymeric with a semi-elemental oral nutritional supplement on fluid and sodium status in patients with a jejunostomyAlison Culkin0Beth Rye1Jeremy MD Nightingale2Corresponding author.; Lennard-Jones Intestinal rehabilitation unit, St Mark’s Hospital, Watford Road, Harrow, UKLennard-Jones Intestinal rehabilitation unit, St Mark’s Hospital, Watford Road, Harrow, UKLennard-Jones Intestinal rehabilitation unit, St Mark’s Hospital, Watford Road, Harrow, UKBackground: Patients with a short bowel need to restrict oral fluid to reduce stoma/fistula output. Some patients require oral nutritional supplements (ONS) to meet nutritional requirements. There is limited research on ONS for patients with a short bowel. This study aimed to compare polymeric verses semi-elemental ONS on jejunal wet weight and sodium output. Materials and methods: Patients were included if they had < 200 cm of small bowel to a jejunostomy or an enterocutaneous fistula. Patients fasted from midnight then were randomly allocated to consume 200 ml of either Vital 1.5® or Ensure Plus® over 30 min. Jejunal output and urine were collected for 6 h during which patients remained nil by mouth. Jejunal and urine outputs were weighed, and samples sent for analysis. After a day washout, patients were swapped to the other ONS. Differences between the two study periods were assessed using multilevel regression. Results: Ten patients completed, 4 females: 6 males, mean age 59.2 years, mean small bowel length 95 cm. Jejunal wet weight (P < 0.001) and jejunal sodium (P = 0.003) were significantly higher on Vital 1.5® compared to Ensure Plus® with a mean difference of 0.1 kg and13mmol respectively. There was no difference in faecal sodium balance (P = 0.16), urine sodium (P = 0.38) or urine volume (P = 0.56). Conclusion: A semi-elemental ONS results in a greater jejunal wet weight loss compared to a polymeric one. The amount is small but the daily cumulative loss will be greater.http://www.sciencedirect.com/science/article/pii/S2950456224000022Short bowelIntestinal failureHigh output stomaEnterocutaneous fistulaOral nutritional supplements |
| spellingShingle | Alison Culkin Beth Rye Jeremy MD Nightingale A randomised controlled crossover trial comparing a polymeric with a semi-elemental oral nutritional supplement on fluid and sodium status in patients with a jejunostomy Intestinal Failure Short bowel Intestinal failure High output stoma Enterocutaneous fistula Oral nutritional supplements |
| title | A randomised controlled crossover trial comparing a polymeric with a semi-elemental oral nutritional supplement on fluid and sodium status in patients with a jejunostomy |
| title_full | A randomised controlled crossover trial comparing a polymeric with a semi-elemental oral nutritional supplement on fluid and sodium status in patients with a jejunostomy |
| title_fullStr | A randomised controlled crossover trial comparing a polymeric with a semi-elemental oral nutritional supplement on fluid and sodium status in patients with a jejunostomy |
| title_full_unstemmed | A randomised controlled crossover trial comparing a polymeric with a semi-elemental oral nutritional supplement on fluid and sodium status in patients with a jejunostomy |
| title_short | A randomised controlled crossover trial comparing a polymeric with a semi-elemental oral nutritional supplement on fluid and sodium status in patients with a jejunostomy |
| title_sort | randomised controlled crossover trial comparing a polymeric with a semi elemental oral nutritional supplement on fluid and sodium status in patients with a jejunostomy |
| topic | Short bowel Intestinal failure High output stoma Enterocutaneous fistula Oral nutritional supplements |
| url | http://www.sciencedirect.com/science/article/pii/S2950456224000022 |
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