It provides about 600 cal and 150 g carbohydrate but inadequate protein, vitamins, and minerals. The clear liquid diet supplies fluid and calories in a form that requires minimal digestion, stimulation, and elimination by the GI tract. McNally DO, FACP, FACG, in GI/Liver Secrets (Fourth Edition), 2010 8 Describe the types of commonly prescribed oral diets Vanilla flavored versions of these formulas with or without flavor packets increase palatability. Many MCT-based products such as regular flavored semi-elemental formula with MCT oil and small chain peptides can have a medicinal taste. Unfortunately, most MCT-based products are not very palatable. 189 MCTs do not require chylomicron formation and are absorbed directly into the portal venous system. MCTs have 6- to 12-carbon fatty acid chains, high aqueous solubility, and do not require bile salts for absorption in the small intestine. MCT oil may be used to substitute for long-chain triglycerides. In those patients placed on a low-fat diet for a prolonged period of time, fat-soluble vitamins (A, D, E, K) must be supplemented. Low-fat diets are used to minimize diarrhea and steatorrhea associated with fat malabsorption, especially in patients with pancreatic or biliary dysfunction. High pectin-containing foods, such as bananas and oranges are included in this diet to slow gastric output. 188 Fluid intake should be restricted and separated from solid food intake to avoid rapid gastric transit. Simple sugars are avoided to prevent their rapid absorption. A high-fiber diet emphasizes foods such as vegetables, fruits, legumes, and whole-grain breads and cereals.Ī post-gastrectomy or anti-dumping diet involves ingestion of small, frequent meals high in protein and fat, to deliver a lower-osmolarity solution to the small intestine. Life-long high-fiber diets may help prevent colon cancer. They may also be useful in diabetes by delaying glucose absorption, and in cardiovascular disease by lowering serum cholesterol and serum triglyceride levels. They are used to reduce intraluminal colon pressures in patients with diverticulosis. High-fiber diets include soluble and insoluble fibers, which have a wide range of metabolic and physiologic effects. For gastroparesis, low fat intake is also recommended. Carbohydrate intake is reduced, and well-cooked vegetables, refined cereals, and breads are used instead. Low-fiber, low-residue diets are used for patients with GI strictures as well as those with gastroparesis and are presumed to reduce the risk of obstruction while prolonging transit time. They contain a large amount of simple carbohydrates and should be used with caution in diabetic patients. They are largely milk-based and should not be used for lactose-intolerant patients. 186,187įull liquid diets are indicated for patients who are unable to chew, swallow, or digest solids. In contrast, early EN feeding after abdominal or thoracic surgery may reduce postoperative complications, hospital length of stay, and mortality (although vomiting may be increased). Where possible, clear liquid diets should not be prescribed, as there is no physiologic rationale for their use, they tend to be high in sodium content, and their provision cannot be justified other than fulfilling a patient’s personal wishes. Little evidence suggests that a clear liquid diet is better tolerated than any other diet in the postoperative period. Clear liquid diets generally contain an abundance of carbohydrates but little protein or fat and are thereby nutritionally inadequate to meet basic metabolic needs. They are meant to avoid the high osmolar delivery of nutrients to the GI tract, which would result in fluid shifts and associated nausea and diarrhea. Mark Feldman MD, in Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 2021 Special DietsĬlear liquid diets supply fluid and energy in a form that creates a minimal amount of residue.
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