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The clear liquid diet: When is it appropriate?

Current Gastroenterology Reports volume 4, Article number: 324 (2002) Cite this article

Abstract

Closer attention to the clear liquid diet and its therapeutic applications has been prompted by critical reviews of nutritional enhancement in the clinical environment. The aim of ongoing research has been to uncover the optimal nutrient complement in various patient groups as well as the most beneficial mode of nutrient delivery. Route of feeding is often the essential determinant in effectiveness of nutritional support. Many studies have sought to demonstrate the superiority of enteral versus parenteral nutrition, whereas comparative studies with clear liquid diets are sparse. Recently, identification of key nutrients in the support of malnourished or immunocompromised patients has been emphasized. Although total parenteral nutrition has undisputed applications in specific patient groups, it has lost favor for general application because of its negative impact on immunocompetence. Efforts have thus been redoubled to explore the potential of the gastrointestinal tract, with the derived benefit in immunosupport for many medical and surgical disease states. Until recently, the clear liquid diet had not received close scrutiny and had retained an unchallenged position in certain applications (eg, bowel preparation). This paper summarizes the published, theorized, and potential benefits as well as the limitations of the clear liquid diet.

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References and Recommended Reading

  1. Kehlet H, Holte K: Review of postoperative ileus. Am J Surg 2001, 182:3S-10S. A very complete and well-referenced review.

    PubMed  Article  CAS  Google Scholar 

  2. Larson S, Lundberg D: A prospective survey of postoperative nausea and vomiting with special regard to incidence and relations to patient characteristics, anesthetic routines and surgical procedures. Acta Anaesthesiol Scand 1995, 39:539–543.

    Article  Google Scholar 

  3. Furness JB, Kunze WAA, Bornstein JC, Clerc N: The enteric nervous system and its extrinsic connections. In Textbook of Gastroenterology, edn 3. Edited by Yamada T. Philadelphia: Lippincott Williams & Williams; 1999:2–10.

    Google Scholar 

  4. Schippers E, Holscher AH, Bollschweiler E, et al.: Return of interdigestive motor complex after abdominal surgery: end of postoperative ileus? Dig Dis Sci 1991, 36:621–626.

    PubMed  Article  CAS  Google Scholar 

  5. Behrns KE, Kircher AP, Galanko JA, et al.: Prospective randomized trial of early initiation and hospital discharge on a liquid diet following elective intestinal surgery. J Gastrointest Surg 2000, 4:217–222.

    PubMed  Article  CAS  Google Scholar 

  6. Shikora SA, Martindale RG, Schwaitzberg SD: Nutritional Considerations in the Intensive Care Unit: Science, Rationale and Practice. Dubuque, IA: Kendall/Hunt Publishing; 2002.

    Google Scholar 

  7. Webber J, Macdonald IA: Energy metabolism. In Artificial Nutrition Support in Clinical Practice, edn 2. Edited by Payne-James J, Grimble GK, Silk DBA. San Francisco: Greenwich Medical Media Limited; 2001:63–79.

    Google Scholar 

  8. Bodger K, Heatley RV: The immune system and nutrition support. In Artificial Nutrition Support in Clinical Practice, edn 2. Edited by Payne-James J, Grimble GK, Silk DBA. San Francisco: Greenwich Medical Media Limited; 2001:139–148.

    Google Scholar 

  9. Guarino A, Albano F, Guandalini S, for the Working Group on Acute Gastroenteritis: Oral rehydration: toward a real solution. J Pediatr Gastroenterol Nutr 2001, 33:S2-S12.

    PubMed  Article  CAS  Google Scholar 

  10. American Society of Parenteral and Enteral Nutrition Board of Directors: Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients. JPEN J Parenter Enteral Nutr 2002, 26(suppl1):1SA-138SA. This supplement to JPEN offers several articles that are relevant to postoperative nutrition and early feeding.

    Google Scholar 

  11. Jeffery KM, Harkins B, Cresci GA, Martindale RG: The clear liquid diet is no longer a necessity in the routine postoperative management of surgical patients. Am Surg 1996, 62:167–170.

    PubMed  CAS  Google Scholar 

  12. Protocare Corporation: Clear liquid diet. Accessible at http://www.quickcare.org/gast/diet.html. Accessed February 2, 2002.

  13. Eckerwall G, Andersson R: Early enteral nutrition in severe acute pancreatitis: a way of providing nutrients, gut barrier protection, immunomodulation, or all of them? Scand J Gastroenterology 2001, 36:449–458.

    Article  CAS  Google Scholar 

  14. Abou-Assi S, O‘Keefe SJ: Nutrition in acute pancreatitis. J Clin Gastroenterol 2001, 32:203–209.

    PubMed  Article  CAS  Google Scholar 

  15. Lehocky P, Sarr MG: Early enteral feeding in severe acute pancreatitis: can it prevent secondary pancreatic (super) infection? Dig Surg 2000, 17:571–577.

    PubMed  Article  CAS  Google Scholar 

  16. Wernerman J, Hammarqvist F: Bacterial translocation: effects of artificial feeding. Curr Opin Clin Nutr Metabol Care 2002, 5:163–166.

    Article  Google Scholar 

  17. Charney PJ, Martindale RG: Nutrition support in patients with rnterocutaneous fistulas. Support Line: A Newsletter of Dietitians in Nutritional Support 1993, 15:1–4.

    Google Scholar 

  18. Heuschkel RB, Walker-Smith JA: Enteral nutrition in inflammatory bowel disease of childhood. JPEN J Parenter Enteral Nutr 1999, 23:S29-S32.

    PubMed  CAS  Article  Google Scholar 

  19. Bozzetti F: Nutrition support in patients with cancer. In Artificial Nutrition Support in Clinical Practice, edn 2. Edited by Payne-James J, Grimble GK, Silk DBA. San Francisco: Greenwich Medical Media Limited; 2001:641–680.

    Google Scholar 

  20. Aiko S, Yoshizumi Y, Sugiura Y, et al.: Beneficial effects of immediate enteral nutrition after esophageal cancer surgery. Surg Today 2001, 31:971–978.

    PubMed  Article  CAS  Google Scholar 

  21. Schmidt H, Martindale RG: The gastrointestinal tract in critical illness. Curr Opin Clin Nutr Metabol Care 2001, 4:547–551. This well-written and somewhat provocative article reviews the theoretic and practical effects of enteral feeding.

    Article  CAS  Google Scholar 

  22. Braga M, Gianotti L, Cestari A, et al.: Gut function and immune and inflammatory responses in patients perioperatively fed with supplemented enteral formulas. Arch Surg 1996, 131:1257–1265.

    PubMed  CAS  Google Scholar 

  23. Ritz MA, Fraser R, Tam W, Dent J: Impacts and patterns of disturbed gastrointestinal function in critically ill patients. Am J Gastroenterol 2000, 95:3044–3052. This article covers the dysmotility issues involved in maximizing gastrointestinal function in the critically ill. It is extremely up to date and well referenced.

    PubMed  Article  CAS  Google Scholar 

  24. Petrelli NJ, Cheng C, Driscoll D, Rodriguez-Bigas MA: Early postoperative oral feeding after colectomy: an analysis of factors that may predict failure. Ann Surg Oncol 2001, 8:796–800.

    PubMed  Article  CAS  Google Scholar 

  25. Senkal M, Zumtobel V, Bauer K, et al.: Outcome and cost-effectiveness of perioperative enteral immunonutrition in patients undergoing elective upper gastrointestinal tract surgery. Arch Surg 1999, 134:1309–1316.

    PubMed  Article  CAS  Google Scholar 

  26. Tepaske R, te Velthuis H, Oudemans-van Straaten H, et al.: Effect of preoperative oral immune-enhancing nutritional supplement on patients at high risk of infection after cardiac surgery: a randomized placebo-controlled trial. Lancet 2001, 358:696–701.

    PubMed  Article  CAS  Google Scholar 

  27. Bengmark S: Pre-, pro-and synbiotics. Current Opin Clin Nutr Metabol Care 2001, 4:571–579.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Medical College of Georgia, 1120 15th Street, Room 4072, 30912, Augusta, GA, USA

    Susan Hancock MD, Gail Cresci MS, RD, CNSD, LD & Robert Martindale MD, PhD

Authors
  1. Susan Hancock MD
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  2. Gail Cresci MS, RD, CNSD, LD
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  3. Robert Martindale MD, PhD
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Hancock, S., Cresci, G. & Martindale, R. The clear liquid diet: When is it appropriate?. Curr Gastroenterol Rep 4, 324 (2002). https://doi.org/10.1007/s11894-002-0083-2

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  • DOI: https://doi.org/10.1007/s11894-002-0083-2

Keywords

  • Abdominal Aortic Aneurysm
  • Enteral Nutrition
  • Enteral Feeding
  • Postoperative Ileus
  • Oral Rehydration Solution