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Pancreatic Enzyme Supplementation for Patients Receiving Enteral Feeds
Author(s) -
Ferrie Suzie,
Graham Christie,
Hoyle Matthew
Publication year - 2011
Publication title -
nutrition in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.725
H-Index - 71
eISSN - 1941-2452
pISSN - 0884-5336
DOI - 10.1177/0884533611405537
Subject(s) - medicine , enteral administration , pancreatic enzymes , sodium bicarbonate , enzyme , feeding tube , parenteral nutrition , pancreatic juice , digestive enzyme , tube (container) , pancreas , gastroenterology , surgery , amylase , biochemistry , chemistry , mechanical engineering , engineering
Background: Pancreatic enzyme supplementation is an important part of management for a number of gastrointestinal conditions. For patients who are unable to swallow pancreatin capsules or granules, enteral feeding tubes can be used to administer the pancreatic enzyme. This presents challenges given the unique format of the pancreatic enzyme supplements, with common problems including tube blockage and loss of the enzyme's effect. Methods and Results: A novel technique is described for administration of pancreatic enzyme via feeding tubes. For gastrically placed tubes, this involves opening the pancreatin capsules and suspending the enzyme microspheres in thickened acidic fluid (such as the mildly thickened or “nectar‐thick” fruit juice used for dysphagia) for delivery into the feeding tube. This technique minimizes tube blockage by preventing the enzyme from clumping in the tube. For jejunally placed tubes, enzyme microspheres can be crushed and activated with sodium bicarbonate before flushing into the tube, or the activated enzyme mixture can be added to enteral feeds. Conclusions: Pancreatic enzyme supplementation can continue while patients receive enteral feeding. Using the described technique can help to avoid tube blockage and maintain optimal enzyme activity.