Initially diarrhoea is prevented by a restricted fluid and dietary intake. Food is given six times a day with a total of 600 kcal/day. The diet consists of complex carbohydrates (60%) and protein (20%). Good foods include rice, baked potatoes, and pastas with small quantities of chicken, fish and lean meat. Fluid is given as an electrolyte containing drink such as Gatorade, initially this is restricted to 600 ml /day. After 1 month the intake is gradually increased to 1000 kcal/day and 1000 ml/day. Antiperistaltic agents such as lomotil or codein may be taken 20 minutes before meals.
Over the next several months the diet and fluid is slowly increased with an aim to provide 120% of the usual protein and energy requirement.
Improvement in the absorbtive capacity of the bowel during this period are due to intestinal adaptation. Enteral feeding is necessary for adaptation to occur. The role of several hormones and the amino acid glutamine in the promotion of adaptation have been investigated. These are beneficial.
