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Carol Rees Parrish, R.D., MS, Series Editor Enteral ...

PRACTICAL GASTROENTEROLOGY JUNE 200544 INTRODUCTIONIn the last 25 years the number and variety of enteralformulas that are available for use has increased dra-matically. Well over 100 Enteral formulas are nowavailable, making formula selection rather addition, Enteral formulas are considered food sup-plements by the Food and Drug Administration (FDA)and are therefore not under the same regulatory controlas medications. As a result, Enteral formula labels maymake structure and function claims without priorFDA review or approval. Furthermore, there is a lackof prospective, randomized, controlled clinical trialssupporting the purported indications for the majority ofthe specialized formulas currently on the market. Enteral formulas may be classified as standard,elemental or specialized. Many formulas are availablewithin each category, often containing significant dif-ferences in nutrient composition. Standard Enteral for-mulas are defined as ones with intact protein contain-ing balanced amounts of macronutrients and will oftenmeet a patient s nutrient requirements at significantlyless cost than specialized formulas (See Table 1 forEnteral Formula Selection: A Review of Selected Product CategoriesNUTRITION ISSUES IN GASTROENTEROLOGY, Series #28 Carol Rees Parrish, , MS, Series EditorAinsley M.)

mulas available. Persistent hyperkalemia, hyperman-ganesemia, hyperphosphatemia is often the driving factor that leads most clinicians to switch from a stan-dard formula to a renal product. In patients undergoing renal replacement therapy, especially continuous veno-venous hemodialysis (CVVHD), renal formulas are

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