Long-term nutrition support in gastrointestinal disease--a systematic review of the evidence.

OBJECTIVES Patients with gastrointestinal disease or those having undergone gastrointestinal surgery are often at nutritional risk for extended periods after they are discharged from the acute care setting. This systematic review aims to assess the evidence for the use of oral nutrition support, in the form of oral nutrition supplementation or individualized dietary advice in people with gastrointestinal illness, for a prolonged period of time, deemed greater than 2 mo. METHODS A systematic review of relevant databases was conducted from January 1980 until December 2009. Suitable articles were appraised looking at oral nutrition support, for greater than 2 mo, and the association with nutritional outcomes in people with gastrointestinal illness. RESULTS Six studies were identified for this systematic review. The range of patient groups, interventions, and outcomes differed between studies. Overall evidence supports the use of oral nutrition support for improving outcomes such as weight, function, caloric intake, and quality of life. There was a trend toward improved outcomes with individualized dietary advice as the study period increased. CONCLUSIONS There is strong evidence to support the use of oral nutrition support in a long-term setting for gastrointestinal patients. It appears that as the timeframe increases, there may be a greater role for the use of individualized dietary advice over oral nutrition supplementation alone. However, more research is needed in this area.