Clinical use of enteral nutrition.

Enteral Nutrition is among the most developed disciplines in modern Medicine. Technological advances, a better knowledge of malnutrition physiopathology and its involvement in the evolution of several clinical entities have made it possible to improve the nutritional attention paid to our patients. The use of EN has expanded as a first choice practice in patients with undernutrition or at risk of undernutrition that have a minimally functional intestine and are unable to cover their total calorie and protein requirements with natural or supplemented diets. Terms like "medical food" or "organ- or system-specific nutrition" or "pathology-specific nutrition" have revolutionized the EN field in the last 20 years with the emergence of specifically defined formulations. EN has been shown to be cost-effective in patients with malnutrition when the indication is established early. Home and Ambulatory Artificial Nutrition techniques are administratively regulated and, as they are widespread in our country, they allow some cost reductions in certain processes. Occasionally, the introduction, use or withdrawal of EN may constitute a situation of ethical dilema that should be avoided by making use of respect, companionship and shared information between the health team, patients and their substitutes.