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According to results published in the Lancet, postoperative enteral nutrition may significantly reduce complications and the length of hospital stays for patients with gastrointestinal cancer.

The gastrointestinal tract consists of organs that assist in the movement, digestion or assimilation of nutrients from food into the body. The major components are the mouth, esophagus, stomach, small and large intestines, colon, rectum and anus. The esophagus carries the food to the stomach, which is the primary organ of digestion. From the stomach, food moves into the small intestines, where it is further broken down, then into the large intestine, where most of the nutrients are absorbed. Any remaining waste exits the body by continuing through the colon, rectum and out the anus.

Patients with gastrointestinal cancer are often malnourished because they are unable to eat or, if they can eat, their cancer may prevent the normal breakdown and/or absorption of nutrients from food. Malnourishment weakens the immune system and makes it more difficult for a patient to recover from treatment. Two types of feeding methods are used in such cases: enteral and parenteral. Enteral nutrition is the introduction of nutrients directly into the gastrointestinal tract by a feeding tube while parenteral nutrition infuses nutrients into the body through a vein. Most physicians believe that enteral feeding produces more favorable results, but little research has been done on this subject.

A multi-study clinical trial conducted in Italy compared the effectiveness of parenteral and enteral nutrition in patients undergoing surgery for gastrointestinal cancer. In this study, 159 patients received enteral nutrition and 158 were given parenteral nutrition, both containing equal amounts of energy and amino acids (the building blocks of protein).

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Postoperative complications for patients who received enteral nutrition were significantly lower than for patients who received parenteral nutrition (34% versus 49%). Patients fed enterally also had significantly shorter hospital stays than patients fed parenterally. However, patients did not tolerate enteral nutrition as well parenteral feeding. Adverse effects occurred in 35% of patients fed enterally and in 14% of patients fed parenterally. Additionally, 14 patients receiving enteral nutrition switched to parenteral feeding during the study.

An Italian clinical trial suggests that enteral nutrition significantly reduces postoperative complications and the length of hospital stays for patients with gastrointestinal cancer, even though it is not as well tolerated as parenteral feeding. Individuals with gastric cancer considering surgery may wish to discuss with their physician the risks and benefits of enteral nutrition.

The Lancet, Vol 358, No 9292, pp 1487-1492, 2001)