Intestinal permeability in patients after surgical trauma and effect of enteral nutrition versus parenteral nutrition.
OBJECTIVE
To study the intestinal permeability (IP) following stress of abdominal operation and the different effects on IP of enteral nutrition (EN) and parenteral nutrition (PN).


METHODS
Forty patients undergoing abdominal surgery were randomized into EN group and PN group. Each group received nutritional support of the same nitrogen and calorie from postoperative day (POD) 3 to POD 11. On the day before operation (POD-1), POD 7 and POD 12, 10 g of lactulose and 5 g of mannitol were given orally, and urine was collected for 6 hours. Urine excretion ratios of lactulose and mannitol (L/M) were measured.


RESULTS
L/M ratios of EN group on POD-1, POD 7 and POD 12 were 0.026+/-0.017, 0.059+/-0.026, 0.027+/-0.017, respectively, and those of PN group were 0.025+/-0.013, 0.080+/-0.032, 0.047+/-0.021, respectively. Patients of both groups had elevated L/M ratios on POD 7 vs. POD-1. However the ratio returned toward control level in EN group by POD 12. In contrast, PN group still had elevated L/M ratios on POD 12.


CONCLUSIONS
L/M ratio increases for a period of time after surgical trauma and the loss of gut mucosal integrity can be reversed by substitution of enteral nutrition.
Jiang
Xiao-Hua
XH
Research Institute of General Surgery, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, China. dr_jxh@163.com
Li
Ning
N
Li
Jie-Shou
JS
D000328:Adult; D000368:Aged; D004067:Digestive System Neoplasms / Q000601:surgery*; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism*; D007422:Intestines / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition; D010539:Permeability; D011184:Postoperative Period; D013997:Time Factors