Improvement in protein absorption with a small-peptide-based diet in patients with high jejunostomy.
We compared urinary and fecal excretions of fluid, electrolytes, and nutrients in six patients with a high jejunostomy during three randomized consecutive 3-day periods of total enteral nutrition with three diets differing only by the degree of hydrolysis of the protein moiety: whole proteins, their hydrolysate (63% nitrogen as small peptides with < 1000 M), and the two mixed together. Daily nitrogen absorption was significantly enhanced with the small-peptide and mixed diets (14.3 +/- 3.4 and 13.1 +/- 2 g, respectively) compared with the whole protein diet (10.9 +/- 2.4 g, p = 0.012). Concomitantly, blood urea nitrogen and urinary urea excretion increased with the small-peptide diet. Apparent absorption of fat and calories, fecal weight, and urinary and fecal excretions of sodium, potassium, calcium, and magnesium remained unchanged. We conclude that a small-peptide-based diet may be beneficial in patients with short-bowel syndrome.
Cosnes
J
J
Service d'Hepatogastroenterologie et de Nutrition, Hôpital Rothschild, Paris, France.
Evard
D
D
Beaugerie
L
L
Gendre
J P
JP
Le Quintrec
Y
Y
D000368:Aged; D001806:Blood Urea Nitrogen; D004041:Dietary Fats / Q000378:metabolism; D004044:Dietary Proteins / Q000008:administration & dosage / Q000378:metabolism*; D002149:Energy Intake; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D007408:Intestinal Absorption; D007582:Jejunostomy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D008903:Minerals / Q000378:metabolism; D009584:Nitrogen / Q000378:metabolism; D010455:Peptides / Q000008:administration & dosage / Q000378:metabolism*; D012778:Short Bowel Syndrome / Q000209:etiology / Q000378:metabolism*; D014508:Urea / Q000652:urine
D004041:Dietary Fats; D004044:Dietary Proteins; D008903:Minerals; D010455:Peptides; D014508:Urea; D009584:Nitrogen