Comparison of an elemental and two polymeric diets in colectomized patients with or without intestinal resection.

The absorption of nutrients and minerals from the small bowel on enteral diets of different composition has been studied in seven ileostomy patients without or with only minor (< 100 cm) distal small bowel resection (group A) and in nine patients with major (> 100 cm) resections, i.e. jejunostomies (group B). In group A, a moderate-fat polymeric diet (MF) was compared to a peptide-based low-fat elemental diet (PD). Nitrogen and potassium absorption was higher on the MF, while the absorption of other nutrients and minerals studied did not differ. In group B a low-fat polymeric diet (LF) was also tested. Jejunostomy volumes were higher on the PD diet compared to the polymeric diets, as were losses of sodium and potassium. Nitrogen absorption was lower on the PD diet. Comparison of the MF and LF polymeric diets showed equal energy losses, while jejunostomy volumes and sodium losses were higher on the MF diet. Calcium absorption was higher and balance better on the LF diet. We conclude, that (a) elemental diets offer no nutritional advantages in enteral feeding of patients with intact or impaired small bowel function, and (b) we suggest that a low-fat polymeric diet could replace elemental diets in patients with malabsorption.