Zarling E J, Edison T, Berger S, Leya J, DeMeo M
Department of Medicine, Loyola University Medical Center, Maywood, IL 60153.
J Am Coll Nutr. 1994 Dec;13(6):565-8. doi: 10.1080/07315724.1994.10718448.
The role of fiber in tube feeding products has not clearly been defined. While some studies suggest that fiber can increase stool weight and bowel transit time in acutely ill patients, there is less information in stable patients receiving chronic enteral nutritional support.
Using a crossover study design, we investigated the effect of 28.8 g/day of a 50% soy and 50% oat fiber combination in 10 medically stable residents of a chronic care facility. Subjects were randomized to initially receive 10 days of either Isocal HN or Ultracal, which are identical in composition except Ultracal contains 14.4 g/L of fiber. After the first 10-day study, subjects underwent a washout followed by a second 10-day study using the other product. Fecal dye markers were used to identify appropriate collection times.
Fiber significantly increased the number of bowel movements per day (0.9 +/- 0.4 vs 0.5 +/- 0.2, p < 0.05) and fecal weights (57 +/- 31 vs 32 +/- 25 g/day, p < 0.05). Fiber also caused a significant increase in fecal nitrogen output (110 +/- 65 vs 75 +/- 74 mg/day, p < 0.05) and fecal energy (141 +/- 73 vs 76 +/- 62 kcal/day, p < 0.05). Fiber did not affect fecal moisture, gastric emptying, or intestinal transit time.
We conclude that the addition of a combination of soy and oat fiber to tube feeding material is well tolerated, and promotes regular bowel movements without altering the rate of gastric emptying or intestinal transit time.
管饲产品中纤维的作用尚未明确界定。虽然一些研究表明,纤维可增加急性病患者的粪便重量和肠道转运时间,但对于接受长期肠内营养支持的稳定患者,相关信息较少。
采用交叉研究设计,我们调查了在一家慢性病护理机构中10名病情稳定的居民中,每天补充28.8克50%大豆纤维与50%燕麦纤维组合的效果。受试者被随机分为两组,最初10天分别接受Isocal HN或Ultracal,这两种产品成分相同,只是Ultracal含有14.4克/升的纤维。在第一个为期10天的研究结束后,受试者经过洗脱期,然后使用另一种产品进行第二个为期10天的研究。使用粪便染料标记物来确定合适的收集时间。
纤维显著增加了每天的排便次数(0.9±0.4次对0.5±0.2次,p<0.05)和粪便重量(57±31克/天对32±25克/天,p<0.05)。纤维还导致粪便氮排出量显著增加(110±65毫克/天对75±74毫克/天,p<0.05)和粪便能量显著增加(141±73千卡/天对76±62千卡/天,p<0.05)。纤维对粪便水分、胃排空或肠道转运时间没有影响。
我们得出结论,在管饲材料中添加大豆和燕麦纤维的组合耐受性良好,并能促进规律排便,而不会改变胃排空率或肠道转运时间。