Hydrolyzed Versus Nonhydrolyzed Protein Diet in Short Bowel Syndrome in Children

Abstract

ABSTRACTBackgroundThere is no consensus regarding the optimal enteral formula in patients with neonatal short bowel syndrome. The common practice in many centers is to give a semielemental diet.MethodsTo test the hypothesis that hydrolyzed protein is not superior to standard formula in promoting growth and development of children with short bowel syndrome, 10 children aged 4.08 ± 2.45 months (mean ± SD) underwent a prospective, randomized, crossover, double‐blind study lasting 60 days (with crossover on day 31). Two enteral formulas, which differed only with respect to the nitrogen form—hydrolyzed and nonhydrolyzed whey protein—were used. The endpoints of the study were nitrogen balance and intestinal permeability measured by the sugar absorption test (lactulose/mannitol excretion ratio).ResultsEnergy intake from enteral formula in patients fed hydrolyzed and nonhydrolyzed formula was the same and amounted to about 31% of total intake. The ratio of total energy intake (enteral and parenteral) to resting energy expenditure was 1.7 ± 0.5 and 1.5 ± 0.3 in patients fed hydrolyzed and non hydrolyzed formula respectively. Nitrogen balance was 0.28 ± 0.05 g/kg/d and 0.29 ± 0.05 g/kg/day, respectively. Lactulose/mannitol ratio before the study was 0.85 ± 0.85 and after hydrolyzed and nonhydrolyzed formula was 0.59% ± 0.51% and 0.69% ± 0.72%, respectively.ConclusionIntestinal permeability, energy, and nitrogen balance in short bowel syndrome were not influenced in the short term by hydrolysis of the enteral nitrogen source.