The effect of viscosity regulating solution for enteral nutrition against gastro esophageal reflux

Abstract

Care is needed in administering enteral nutrition (EN). If administered to fast in a misguided attempt to save time, it may cause severe diarrhea, malnutrition, and other metabolic disorders, and worst of all aspiration pneumonia. We developed a pectin solution easily added to conventional EN solution to modulate viscosity, enable recipients to be given EN administered in a short time while preventing aspiration pneumonia, enabling them to have more time to recover. Subjects and Methods: We studied changes in viscosity of conventional EN solution (K-3S) containing 60 mg of calcium ion when 90g of viscosity regulating gel forming pectin solution (REF-P1) was added. Four healthy volunteers were rapidly administered EN and the influence of viscosity alternation by supplementary REF-P1 against gastro esophageal reflux was monitored by gastro esophageal pH. Preliminary clinical study was carried out using K-3S and REF-P1 at 9 institutions in 16 patients with repetitive aspiration under EN management is introduced. Results: The addition of Ref-P1 to conventional EN solution increased viscosity from 8 centi pores (cp) to 860 cp. Rapid administration of K-3S to healthy volunteers caused gastro-esophageal reflux prevented by supplementary REF-P1 with viscosity elevation. The reflux rate (%) for K-3S alone was 2.1%. The reflux rate with REF-P1 added decreased to 0.3%. The usage of REF-P1 ameliorated reflux aspiration during EN administration, and decreased the incidence of vomiting, diarrhea, and febris. Summary: We focused on improving EN management by elevating the viscosity of K-3S to prevent aspiration. K-3S forms a gel in the stomach through additional REF-P1 and prevents gastro esophageal reflux disorder (GERD) resulting in aspiration pneumonia. It also shortened administration. This is thus useful in managing EN and gives patients more time to recover.