Background: There 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. Methods: To 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). Results: Energy 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. Conclusion: Intestinal permeability, energy, and nitrogen balance in short bowel syndrome were not influenced in the short term by hydrolysis of the enteral nitrogen source.

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Journal of Pediatric Gastroenterology and Nutrition
Department of Pediatric Surgery

Ksiazyk, J, Piena, M, Kierkus, J, & Lyszkowska, M. (2002). Hydrolyzed versus nonhydrolyzed protein diet in short bowel syndrome in children. Journal of Pediatric Gastroenterology and Nutrition, 35(5), 615–618. doi:10.1097/00005176-200211000-00005