1. Oral nutrition
High-calorie (50-60 kcal / kg / d), liquid-rich, nutrient-rich and low-fiber diet
Goal: easily digestible food, light balanced diet
Limitation of long-chain fats and replacing them with medium-chain fats (up to 50% of energy intake.); Adequate supply of essential fatty acids
Protein content about 20% of energy intake (1.5 – 2.0 g / kg / d), milk protein (calcium!) desirable (yoghurt, quark, low fat cheese)
Wholemeal bread and soft vegetables, initially beginning with freshly squeezed vegetable juices; if this is conventionally impossible, it should be supplemented by nutrient-defined or chemically defined formula diets (as nutritional drinks or by feeding tube)
Initial addition of vitamins (after extensive removal): 100 mg orally on a daily basis
Frequent (6-9) smaller meals and, initially, only drinking between meals, alcohol abstinence
Recommendable as long-term diet if oral food intake is not sufficient anymore
Pump-controlled (mostly during the night) feeding, adapted to the patient?s metabolism, initially diluted, nutrient-defined formula diet. Oligopeptide diet (with > 75% loss of the small intestine)
Calculating the energy content, the nutrient composition and the drug-based nutrient supply based on the same principles as with the oral diet
Recommendable as long-term diet with severely shortened remaining bowel (not always with less than 60 cm), if the dietary condition has not improved or stabilzed through tube feeding
In addition to parenteral nutrition, oral or enteral feeding (where practicable) should always be tried to support the recovery and functional adaptation of the remaining intestine (“absorption training”)