PD379 - MANAGEMENT OF ENTERAL FEEDING INTOLERANCE USING ELEMENTAL NUTRITION: A CLINICAL CASE SERIES ACROSS ACUTE AND CHRONIC GASTROINTESTINAL CONDITIONS

PD379

MANAGEMENT OF ENTERAL FEEDING INTOLERANCE USING ELEMENTAL NUTRITION: A CLINICAL CASE SERIES ACROSS ACUTE AND CHRONIC GASTROINTESTINAL CONDITIONS

B. Samant^1,*, S. J. Chisti¹

¹Kokilaben Dhirubhai Ambani Hospital & medical Research institute, Mumbai, India

Rationale: Gastrointestinal intolerance often limits effective enteral nutrition in complex GI disorders, causing diarrhoea, malabsorption, abdominal pain, and worsening nutrition. When semi-elemental formulas are not tolerated, elemental formulas—made of free amino acids, medium-chain triglycerides, and low osmolarity (330–400 mOsmol)—can improve tolerance and nutrient absorption by reducing digestive effort. Hence, this study aims to evaluate their effectiveness in improving tolerance and absorptive efficiency in complex clinical conditions.

Methods: This case series included five adults (35–70 years) with gastrointestinal intolerance due to GVHD, sigmoid diverticulitis, neutropenic enterocolitis, malabsorption, and sepsis-associated osmotic diarrhea. All had feeding intolerance despite semi-elemental nutrition, including bloating, high-output diarrhea (>1 L/day), abdominal pain, and poor absorption. Elemental feeding was given via continuous nasogastric or jejunal tube for 2 weeks to reduce symptoms and stabilize nutrition. Outcomes assessed were stool frequency and volume, weight change, serum albumin, and inflammatory markers such as C-reactive protein.

Results: All five patients demonstrated enhanced GI function and enteral tolerance within one week of elemental feeding. Stool volume decreased by 70% in diarrheal cases, with reduced intestinal burden, improved absorption, and stabilized weight. By 2 weeks, albumin increased and CRP decreased, indicating better nutritional status. No feeding-related adverse events were observed.

Conclusion: Elemental formulas with low osmolarity may effectively reduce intestinal workload, enhance absorption, and support continued enteral nutrition in high-risk patients, though larger controlled studies are needed to confirm their role and guide clinical practice.

Disclosure of Interest: None declared