Gastric and Jejunal Enteral Feeding Differently Affect Vitamin B₁₂ Status in Subjects with Severe Motor and Intellectual Disabilities

Abstract

The absorption of vitamin B12 is a complex process involving gastric acid and intrinsic factor as the indispensable components. In this study, we have investigated the effects of the administration site in enteral feeding on vitamin B 12 status in subjects with severe motor and intellectual disabilities (SMID). This is a cross-sectional study conducted from January to June 2016. Blood concentrations of vitamin B12, folate, vitamin B6, and homocysteine (Hcy) were measured in a total of 82 subjects (38 men, 44 women). Also, nutrients intake was assessed. Subjects with enteral feeding (EF) had significantly higher intakes of vitamin B12, folate, and vitamin B6 than those with oral ingestion (OI). Serum folate and vitamin B6 concentrations in subjects with EF were significantly higher than those with OI. Among the EF subjects, serum vitamin B12 concentration was significantly higher in those fed with gastric tube than those fed with jejunal tube in spite of similar vitamin B12 intakes. No significant difference was observed between the two groups regarding the circulating concentrations of folate, vitamin B6, or Hcy. Although each administration route has its own benefit, gastric tube is advantageous in the absorption of vitamin B12.

Upper Gastrointestinal Disorders in Adult Patients with Intellectual and Developmental Disabilities

“…Another study showed that serum levels of folate and vitamin B6 are significantly higher in patients with severe motor or IDD using enteral feeding when compared to oral feeds. This study also demonstrated that among patients using enteral feeds, levels of B12 are significantly higher when using a gastrostomy tube compared to a jejunostomy tube [40]. However, gastrostomy tubes have been demonstrated to be inferior to jejunostomy tubes in prevention of aspiration pneumonia due to less likelihood of displacement or clogging [41].…”