Ehrlein H, Stockmann A
Institute of Physiology, University of Hohenheim, Stuttgart, Germany.
Dig Dis Sci. 1998 Sep;43(9):2099-110. doi: 10.1023/a:1018823701554.
Enteric feeding is often associated with diarrhea. To avoid this side effect, isoosmotic and fiber-supplemented enteral diets are recommended. The aims of this study were to determine whether supplementing enteral diets with soy fiber influences nutrient absorption and whether in enteric feeding absorption of nutrients and water fluxes differ between hyperosmotic oligomeric and isoosmotic polymeric diets. In mini pigs intestinal absorption and water fluxes were measured by perfusing a 150-cm length of jejunum. Six noncommercial iso- and hyperosmotic oligomeric and polymeric diets and six commercial polymeric diets, either fiber-free or supplemented with soy fiber, were used. Pancreatic enzymes were infused concomitantly with the polymeric diets. The absorption of nutrients and energy did not differ between oligomeric and polymeric diets. Oligomeric diets of high energy density produced a pronounced secretion of water. Despite lower initial osmolality, polymeric diets produced a similar secretion of water due to rapid pancreatic hydrolysis. Supplementing diets with largely insoluble soy fiber increased viscosity only between 4.6 and 14.5 mPa x sec. Soy fiber did not influence absorption of nutrients and energy and had also no effects on luminal transit and flow rate. The lack of effects was not due to dilution of chyme by intestinal secretion of water because no differences existed between isoosmotic and hyperosmotic oligomeric diets. In conclusion, supplementing enteral diets with soy fiber does not impair the absorption of nutrients. Enteric feeding with isoosmotic polymeric diets provides no advantage compared with hyperosmotic oligomeric diets with respect to absorption of nutrients and secretion of water.
肠内喂养常伴有腹泻。为避免这种副作用，建议采用等渗且添加纤维的肠内饮食。本研究的目的是确定在肠内饮食中添加大豆纤维是否会影响营养物质的吸收，以及在肠内喂养时，高渗低聚饮食和等渗聚合饮食之间营养物质的吸收和水通量是否存在差异。在小型猪中，通过灌注150厘米长的空肠来测量肠道吸收和水通量。使用了六种非商业性的等渗和高渗低聚及聚合饮食，以及六种商业性聚合饮食，有无添加大豆纤维。在给予聚合饮食的同时输注胰酶。低聚饮食和聚合饮食之间营养物质和能量的吸收没有差异。高能量密度的低聚饮食会导致明显的水分泌。尽管初始渗透压较低，但由于胰酶快速水解，聚合饮食也会产生类似的水分泌。添加大量不溶性大豆纤维仅使粘度增加了4.6至14.5毫帕·秒。大豆纤维不影响营养物质和能量的吸收，对肠腔内转运和流速也没有影响。缺乏影响并非由于肠道分泌的水对食糜的稀释，因为等渗和高渗低聚饮食之间没有差异。总之，在肠内饮食中添加大豆纤维不会损害营养物质的吸收。在营养物质吸收和水分泌方面，与高渗低聚饮食相比，等渗聚合饮食的肠内喂养没有优势。
