[Enteral nutrition in the therapy of gastrointestinal diseases (according to materials of the European Association of Parenteral and Enteral Nutrition)].

The present article gives evidence-based recommendations for the indication, application and type of formula of enteral nutrition (EN) (oral nutrition supplements (ONS) or tube feeding (TF)) in patients with Crohn's disease (CD), ulcerative colitis (UC), short bowel syndrome (SBS), acute and chronic pancreatitis, alcoholic steatogepatitis and cirrosis. ONS and/or TF in addition to normal food is indicates in undernourished patients with CD or UC to improve nutritional status. In active CD EN is the first line therapy in children and should be used as sole therapy in adults mainly when treatment with corticosteroids is not feasible. No significant differences have been shown in the effects of free amino acid, peptide-based and hole protein formulae for TF. In remission ONS is recommended only in steroid dependent patients in CD. In patients with SBS TF should be introduced in the adaptation phase and should be changed with progressing adaptation to ONS in addition to normal food. Special nutrition support should not be used routinely in patients with mild or moderate acute pancreatitis. EN is the preffered route in patients with pancreatitis and should be attempted before initiating parenteral nutrition. Nutrition assessment in patients with liver disease should include screening for micronutrient deficiencies. Protein restriction should be implemented for the acute management of hepatic encephalopathy and should not be implemented chronically in patients with liver disease.