Enteral Formula Containing Egg Yolk Lecithin Improves Diarrhea.
Diarrhea often occurs during enteral nutrition. Recently, several reports showed that diarrhea improves by adding egg yolk lecithin, an emulsifier, in an enteral formula. Therefore, we evaluated if this combination could improve diarrhea outcomes. We retrospectively investigated the inhibitory effects on watery stools by replacing a polymeric fomula with that containing egg yolk lecithin. Then, we investigated the emulsion stability in vitro. Next, we examined the lipid absorption using different emulsifiers among bile duct-ligated rats and assessed whether egg yolk lecithin, medium-chain triglyceride, and dietary fiber can improve diarrhea outcomes in a rat model of short bowel syndrome. Stool consistency or frequency improved on the day after using the aforementioned combination in 13/14 patients. Average particle size of the egg yolk lecithin emulsifier did not change by adding artificial gastric juice, whereas that of soy lecithin and synthetic emulsifiers increased. Serum triglyceride concentrations were significantly higher in the egg yolk lecithin group compared with the soybean lecithin and synthetic emulsifier groups in bile duct-ligated rats. In rats with short bowels, the fecal consistency was a significant looser the dietary fiber (+) group than the egg yolk lecithin (+) groups from day 6 of test meal feedings. The fecal consistency was also a significant looser the egg yolk lecithin (-) group than the egg yolk lecithin (+) groups from day 4 of test meal feeding. The fecal consistency was no significant difference between the medium-chain triglycerides (-) and egg yolk lecithin (+) groups. Enteral formula emulsified with egg yolk lecithin promotes lipid absorption by preventing the destruction of emulsified substances by gastric acid. This enteral formula improved diarrhea and should reduce the burden on patients and healthcare workers.
['Akashi|Tetsuro|T|', 'Muto|Ayano|A|', 'Takahashi|Yayoi|Y|', 'Nishiyama|Hiroshi|H|']
D000368:Aged D000818:Animals D003967:Diarrhea D004063:Digestion D004195:Disease Models, Animal D004530:Egg Yolk D045703:Emulsifying Agents D004750:Enteral Nutrition D005260:Female D005744:Gastric Acid D006801:Humans D066298:In Vitro Techniques D054709:Lecithins D008297:Male D008954:Models, Biological D017207:Rats, Sprague-Dawley D012189:Retrospective Studies D012778:Short Bowel Syndrome D013270:Stomach D014280:Triglycerides
lecithins diarrhea enteral nutrition emulsifier lipid absorption