The present article gives evidence-based recommendations for the indication, application and type of formula of
enteral nutrition (EN) (oral nutrition supplements (ONS) or
tube feeding (TF)) in patients with
Crohn's disease (CD),
ulcerative colitis (UC),
short bowel syndrome (SBS), acute and
chronic pancreatitis, alcoholic steatogepatitis and cirrosis. ONS and/or TF in addition to normal food is indicates in undernourished patients with CD or UC to improve nutritional status. In active CD EN is the first line
therapy in children and should be used as sole
therapy in adults mainly when treatment with
corticosteroids is not feasible. No significant differences have been shown in the effects of free
amino acid,
peptide-based and hole
protein formulae for TF. In remission ONS is recommended only in
steroid dependent patients in CD. In patients with SBS TF should be introduced in the adaptation phase and should be changed with progressing adaptation to ONS in addition to normal food. Special nutrition support should not be used routinely in patients with mild or moderate
acute pancreatitis. EN is the preffered route in patients with
pancreatitis and should be attempted before initiating
parenteral nutrition. Nutrition assessment in patients with
liver disease should include screening for
micronutrient deficiencies.
Protein restriction should be implemented for the acute management of
hepatic encephalopathy and should not be implemented chronically in patients with
liver disease.