From the Guidelines
Peptamen is indicated for patients with impaired gastrointestinal function who require specialized nutritional support, particularly those with conditions such as short bowel syndrome, inflammatory bowel disease, pancreatitis, cystic fibrosis, radiation enteritis, or following GI surgery, as supported by the most recent guideline from 2021 1.
Indications for Peptamen Use
The use of Peptamen, a peptide-based formula, is recommended for patients who have impaired gastrointestinal function and require specialized nutritional support. This includes individuals with:
- Short bowel syndrome
- Inflammatory bowel disease
- Pancreatitis
- Cystic fibrosis
- Radiation enteritis
- Following GI surgery
Administration Guidelines
When administering Peptamen, it is essential to follow specific guidelines to ensure tolerance and effectiveness:
- Start with a diluted formula (usually half-strength) at a slow rate of 20-30 mL/hour when delivered via tube feeding, gradually increasing to the target rate as tolerated.
- For oral consumption, patients should begin with small volumes (60-120 mL) several times daily, increasing as tolerated.
- The total daily volume depends on the patient's caloric needs, typically ranging from 1000-2000 mL per day.
Monitoring for Tolerance
Monitoring for tolerance is crucial when using Peptamen, including checking for:
- Abdominal distension
- Diarrhea
- Vomiting
Mechanism of Action
Peptamen works effectively because its medium-chain triglycerides require minimal pancreatic enzymes for digestion, and its peptides can be absorbed directly through the intestinal wall, bypassing the need for complete protein digestion, making it ideal for compromised GI systems, as noted in earlier guidelines 1. However, the most recent and highest quality study from 2021 1 supports its use in clinical practice, prioritizing morbidity, mortality, and quality of life as outcomes.
From the Research
Indications for Peptamen
- Peptamen is a peptide-based formula used in patients with impaired gastrointestinal function, particularly those with short bowel syndrome (SBS) or other conditions that affect nutrient absorption 2, 3, 4, 5.
- The formula is designed to provide essential nutrients and support intestinal adaptation in patients with compromised gut function.
Usage Guidelines
- Peptamen can be used in the early post-operative period to support nutritional recovery in patients who have undergone gastrectomy due to stomach cancer 6.
- The formula may be beneficial in patients with moderate to severe protein-energy malnutrition, as it can help improve nutrient absorption and reduce post-operative complications.
- In patients with SBS, Peptamen may be used as part of a comprehensive nutritional management plan, which may include parenteral nutrition, to support intestinal adaptation and reduce malabsorption 2, 5.
Key Considerations
- The use of Peptamen should be individualized based on the patient's specific nutritional needs and gastrointestinal function.
- Close monitoring of the patient's nutritional status and gastrointestinal function is essential to ensure optimal outcomes and minimize potential complications.
- Peptamen may be used in conjunction with other nutritional therapies, such as parenteral nutrition, to support patients with complex nutritional needs 2, 5.