Utility of a specialized peptide-based enteral formula containing medium-chain triglycerides in provision of enteral tube feeding in children with cerebral palsy: data from prospective observational tolerup study

Diarrhoea is a common and serious complication of enteral tube feeding. Its pathogenesis involves antibiotic prescription, enteropathogenic colonization and abnormal colonic responses, all of which involve an interaction with the colonic microbiota. Alterations in the colonic microbiota have been identified in patients receiving enteral tube feeding and these changes may be associated with the incidence of diarrhoea. Preventing negative alterations in the colonic microbiota has therefore been investigated as a method of reducing the incidence of diarrhoea. Probiotics and prebiotics may be effective because of their suppression of enteropathogenic colonization, stimulation of immune function and modulation of colonic metabolism. Randomized controlled trials of probiotics have produced contrasting results, althoughSaccharomyces boulardiihas been shown to reduce the incidence of diarrhoea in patients in the intensive care unit receiving enteral tube feeding. Prebiotic fructo-oligosaccharides have been shown to increase the concentration of faecal bifidobacteria in healthy subjects consuming enteral formula, although this finding has not yet been confirmed in patients receiving enteral tube feeding. Furthermore, there are no clinical trials investigating the effect of a prebiotic alone on the incidence of diarrhoea. Further trials of the efficacy of probiotics and prebiotics, alone and in combination, in preventing diarrhoea in this patient group are warranted.

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Gastrostomy tube feeding of children with cerebral palsy: variation across six European countries

Developmental Medicine & Child Neurology ◽

10.1111/j.1469-8749.2012.04391.x ◽

2012 ◽

Vol 54 (10) ◽

pp. 938-944 ◽

Cited By ~ 31

Author(s):

MAGNUS O DAHLSENG ◽

GURO L ANDERSEN ◽

MARIA DA GRACA ANDRADA ◽

CATHERINE ARNAUD ◽

RAJESH BALU ◽

...

Keyword(s):

Cerebral Palsy ◽

Tube Feeding ◽

Gastrostomy Tube ◽

European Countries ◽

Children With Cerebral Palsy

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Gastrostomy tube feeding in children with cerebral palsy: a prospective, longitudinal study

Developmental Medicine & Child Neurology ◽

10.1017/s0012162205000162 ◽

2005 ◽

Vol 47 (2) ◽

pp. 77-85 ◽

Cited By ~ 132

Author(s):

Peter B Sullivan ◽

Edmund Juszczak ◽

Allison ME Bachlet ◽

Bridget Lambert ◽

Angharad Vernon-Roberts ◽

...

Keyword(s):

Cerebral Palsy ◽

Longitudinal Study ◽

Tube Feeding ◽

Gastrostomy Tube ◽

Prospective Longitudinal Study ◽

Children With Cerebral Palsy ◽

Prospective Longitudinal

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Gastrostomy tube feeding of children with cerebral palsy

Developmental Medicine & Child Neurology ◽

10.1111/j.1469-8749.2012.04390.x ◽

2012 ◽

Vol 54 (10) ◽

pp. 876-877 ◽

Cited By ~ 1

Author(s):

PETER SULLIVAN

Keyword(s):

Cerebral Palsy ◽

Tube Feeding ◽

Gastrostomy Tube ◽

Children With Cerebral Palsy

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Enteral feeding: the effect on faecal output, the faecal microflora and SCFA concentrations

Proceedings of The Nutrition Society ◽

10.1079/pns2003317 ◽

2004 ◽

Vol 63 (1) ◽

pp. 105-113 ◽

Cited By ~ 40

Author(s):

Kevin Whelan ◽

Patricia A Judd ◽

Victor R. Preedy ◽

Moira A. Taylor

Keyword(s):

Negative Impact ◽

Tube Feeding ◽

Therapeutic Interventions ◽

Faecal Output ◽

Community Environment ◽

Enteral Tube Feeding ◽

Enteral Formula ◽

Definition Of ◽

Conclusive Data ◽

Faecal Microflora

Enteral tube feeding is common in both the hospital and community environment; however, patients can suffer alterations in faecal output that can have serious clinical sequelae. Problems associated with accurate characterisation of faecal output and definition of diarrhoea impede the comparison of research studies and prevent standardised assessment of therapeutic interventions in clinical practice. The colonic microflora may protect the patient against diarrhoea by preventing enteropathogenic infection and by producing SCFA that stimulate colonic water absorption. However, studies in healthy volunteers suggest that the composition of the enteral formula may have a negative impact on the microflora and SCFA concentrations. The addition of fructo-oligosaccharides to the enteral formula may partially prevent negative alterations to the microflora, although conclusive data from studies in patients are not yet available. Modification of the microflora with probiotics and prebiotics may hold potential in prophylaxis against diarrhoea during enteral tube feeding.

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