Enteral Nutrition Therapy: Which Formula Do You Use?

Optimal nutritional status is crucial for the well-being and quality of life of patients who suffer with gastrointestinal disorders due to the significant impairments that can occur through oral tolerance and acceptance, digestive absorption and motility, and weight management. For patients who demonstrate an inability to sustain their nutrition and weight orally, enteral nutrition is an appropriate intervention to help meet nutrient needs. Despite established consensus on indications for the initiation of enteral nutrition, there has been a lack of clear guidelines on proper formulary in respect to gastrointestinal dysfunction. This review focused on the current research comparing the use of standard and peptide-based formulas in respect to gastrointestinal disorders such as inflammatory bowel disease, short bowel syndrome and intestinal failure, pancreatic insufficiency, and gastroparesis.

In summarization of the findings, it was concluded that as a preliminary intervention, a standard, polymeric formulary is an appropriate, cost-effective approach; however, if poor tolerance or response is demonstrated, transitioning to a hydrolyzed formulary is warranted.

As concluded by many of the authors included within this review, a principal takeaway is the importance of demonstrating that the additional expenditure of a specialty formula will realize an improved outcome for the patient and an overall efficient use of resources. One of the limitations found throughout this review is the lack of guidelines for enteral formula recommendations or changes in the clinical outpatient setting, being that most research has focused on an acute care population; however, these settings may still be of best guidance for the treatment of patients experiencing flares, persistent gastrointestinal distress, or poor medical response.