Intestinal permeability after early postoperative enteral nutrition in patients with upper gastrointestinal malignancy

Ari D. Brooks, Steven N. Hochwald, Martin J. Heslin, Lawrence Harrison, Michael Burt, Murray F. Brennan

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background: Increased intestinal permeability may lead to sepsis in resected upper gastrointestinal (GI) cancer patients. This study sought to determine whether these patients demonstrated increased intestinal permeability and if early postoperative enteral nutrition would alter this result. Methods: Nineteen patients undergoing complete resection of upper GI malignancy were randomized into two groups: the nonfed group received IV crystalloid, and the fed group started enteral nutrition by jejunostomy on postoperative day (POD) 1. Six nonoperative volunteers were controls. The lactulose/mannitol test was performed on PODs 1 and 5. Ten grams of lactulose and 5 g of mannitol were given, and urine was collected for 6 hours. Results: All patients (nonfed, 1.895 ± 0.34; fed, 0.893 ± 0.24) had elevated lactulose/mannitol ratios on POD 1 vs controls (0.262 ± 0.1; p < .008 and p = .05). These elevated levels returned toward control levels in both groups by day 5 (nonfed, 0.533 ± 0.1, p = .06; fed, 0.606 ± 0.12, p = .08). Conclusions: Major upper GI surgery for malignancy resulted in a significant increase in intestinal permeability on POD 1. With or without enteral nutrition, this measure of intestinal permeability returned to normal on POD 5 in well-nourished patients.

Original languageEnglish (US)
Pages (from-to)75-79
Number of pages5
JournalJournal of Parenteral and Enteral Nutrition
Volume23
Issue number2
DOIs
StatePublished - Jan 1 1999
Externally publishedYes

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Enteral Nutrition
Permeability
Lactulose
Mannitol
Neoplasms
Jejunostomy
Gastrointestinal Neoplasms
Volunteers
Sepsis
Urine

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Brooks, Ari D. ; Hochwald, Steven N. ; Heslin, Martin J. ; Harrison, Lawrence ; Burt, Michael ; Brennan, Murray F. / Intestinal permeability after early postoperative enteral nutrition in patients with upper gastrointestinal malignancy. In: Journal of Parenteral and Enteral Nutrition. 1999 ; Vol. 23, No. 2. pp. 75-79.
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abstract = "Background: Increased intestinal permeability may lead to sepsis in resected upper gastrointestinal (GI) cancer patients. This study sought to determine whether these patients demonstrated increased intestinal permeability and if early postoperative enteral nutrition would alter this result. Methods: Nineteen patients undergoing complete resection of upper GI malignancy were randomized into two groups: the nonfed group received IV crystalloid, and the fed group started enteral nutrition by jejunostomy on postoperative day (POD) 1. Six nonoperative volunteers were controls. The lactulose/mannitol test was performed on PODs 1 and 5. Ten grams of lactulose and 5 g of mannitol were given, and urine was collected for 6 hours. Results: All patients (nonfed, 1.895 ± 0.34; fed, 0.893 ± 0.24) had elevated lactulose/mannitol ratios on POD 1 vs controls (0.262 ± 0.1; p < .008 and p = .05). These elevated levels returned toward control levels in both groups by day 5 (nonfed, 0.533 ± 0.1, p = .06; fed, 0.606 ± 0.12, p = .08). Conclusions: Major upper GI surgery for malignancy resulted in a significant increase in intestinal permeability on POD 1. With or without enteral nutrition, this measure of intestinal permeability returned to normal on POD 5 in well-nourished patients.",
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Intestinal permeability after early postoperative enteral nutrition in patients with upper gastrointestinal malignancy. / Brooks, Ari D.; Hochwald, Steven N.; Heslin, Martin J.; Harrison, Lawrence; Burt, Michael; Brennan, Murray F.

In: Journal of Parenteral and Enteral Nutrition, Vol. 23, No. 2, 01.01.1999, p. 75-79.

Research output: Contribution to journalArticle

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AU - Brooks, Ari D.

AU - Hochwald, Steven N.

AU - Heslin, Martin J.

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AU - Burt, Michael

AU - Brennan, Murray F.

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N2 - Background: Increased intestinal permeability may lead to sepsis in resected upper gastrointestinal (GI) cancer patients. This study sought to determine whether these patients demonstrated increased intestinal permeability and if early postoperative enteral nutrition would alter this result. Methods: Nineteen patients undergoing complete resection of upper GI malignancy were randomized into two groups: the nonfed group received IV crystalloid, and the fed group started enteral nutrition by jejunostomy on postoperative day (POD) 1. Six nonoperative volunteers were controls. The lactulose/mannitol test was performed on PODs 1 and 5. Ten grams of lactulose and 5 g of mannitol were given, and urine was collected for 6 hours. Results: All patients (nonfed, 1.895 ± 0.34; fed, 0.893 ± 0.24) had elevated lactulose/mannitol ratios on POD 1 vs controls (0.262 ± 0.1; p < .008 and p = .05). These elevated levels returned toward control levels in both groups by day 5 (nonfed, 0.533 ± 0.1, p = .06; fed, 0.606 ± 0.12, p = .08). Conclusions: Major upper GI surgery for malignancy resulted in a significant increase in intestinal permeability on POD 1. With or without enteral nutrition, this measure of intestinal permeability returned to normal on POD 5 in well-nourished patients.

AB - Background: Increased intestinal permeability may lead to sepsis in resected upper gastrointestinal (GI) cancer patients. This study sought to determine whether these patients demonstrated increased intestinal permeability and if early postoperative enteral nutrition would alter this result. Methods: Nineteen patients undergoing complete resection of upper GI malignancy were randomized into two groups: the nonfed group received IV crystalloid, and the fed group started enteral nutrition by jejunostomy on postoperative day (POD) 1. Six nonoperative volunteers were controls. The lactulose/mannitol test was performed on PODs 1 and 5. Ten grams of lactulose and 5 g of mannitol were given, and urine was collected for 6 hours. Results: All patients (nonfed, 1.895 ± 0.34; fed, 0.893 ± 0.24) had elevated lactulose/mannitol ratios on POD 1 vs controls (0.262 ± 0.1; p < .008 and p = .05). These elevated levels returned toward control levels in both groups by day 5 (nonfed, 0.533 ± 0.1, p = .06; fed, 0.606 ± 0.12, p = .08). Conclusions: Major upper GI surgery for malignancy resulted in a significant increase in intestinal permeability on POD 1. With or without enteral nutrition, this measure of intestinal permeability returned to normal on POD 5 in well-nourished patients.

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