title: Effects of Gelatinization of Enteral Nutrients on Human Gastric Emptying.
abstract: BACKGROUND
  Gastrointestinal side effects, particularly diarrhea, are still the main reasons for discontinuation of enteral nutrition. Gelatinization of liquid meal for the prevention of diarrhea has been reported as effective. The purpose of this study was to investigate the effects of gelatinization of liquid meal on gastric emptying.
  
  
  METHODS
  Ten healthy volunteers were studied two times, with 2-week interval between tests. The total calorific value was set at 225 kcal, and 3 test meals were prepared: liquid meal and 2 types of gelatinized meals. These 2 types of gelatinized meals are different viscosity.13C-sodium acetate (100 mg) was thoroughly mixed, and exhaled air was sampled. The results of gastric emptying were expressed as the time of peak excretion (Tmax), and absorption was expressed as the area under the13CO2curve up to Tmax(AUC-Tmax). At the same time, blood samples were collected to measure levels of blood glucose, insulin and gastrin.
  
  
  RESULTS
  The mean value of Tmaxwere 52.0, 77.3 and 85.6 min. Compared to liquid meal, gastric emptying for gelatinized meals was significantly delayed. The mean value of AUC-Tmaxwere 22.7, 28.7 and 33.7%dose, respectively, and no significant differences in absorption were seen. No significant differences existed in blood glucose, gastrin and insulin.
  
  
  CONCLUSIONS
  Gelatinization of liquid meal delays gastric emptying. Gelatinized liquid meal may be useful for the management of diarrhea accompanied with enteral nutrition without influencing gastrointestinal hormone and blood glucose.
authors.affiliation: Department of Surgery, International University of Health and Welfare Hospital, Japan; Department of Surgery, Jikei University School of Medicine, Japan.
authors.forename: Naruo
authors.initials: N
authors.lastname: Kawasaki
authors.affiliation: Division of Clinical Research and Development, Jikei University School of Medicine, Japan.
authors.forename: Mitsuyoshi
authors.initials: M
authors.lastname: Urashima
authors.affiliation: Department of Surgery, International University of Health and Welfare Hospital, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Odaira
authors.affiliation: Department of Surgery, International University of Health and Welfare Hospital, Japan.
authors.forename: Takuji
authors.initials: T
authors.lastname: Noro
authors.affiliation: Department of Surgery, International University of Health and Welfare Hospital, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Suzuki
keywords: 13C breath test; Absorption; Enteral nutrition; Gastric emptying; Gelatinization