Enteral versus parenteral nutrition support-rationale for increased use of enteral feeding.

The enteral route is acknowledged as the preferable route for nutrient administration. Although the ease of enteral administration is possibly overstated, the physiological benefits of enteral feeding are substantial. Enteral feeding reduces hypermetabolism associated with stress via effects on catabolic hormones and preservation of gut mucosal mass. Studies in burns and experimental infections suggest a possible survival benefit from enteral feeding. Enteral feeding promotes better nutrient utilization, may stimulate less glucose recycling and result in less tumor growth than parenteral feeding in cancer. If enteral support can be provided safely with appropriate monitoring and if the gut works, use it.