Nutritional management of gastrointestinal disease

Abstract

The gastrointestinal (GI) tract is primarily responsible for acquiring and digesting food, absorbing nutrients and water, and expelling wastes from the body as feces. A proper diet and normally functioning GI tract are integral for the delivery of nutrients, prevention of nutrient deficiencies and malnutrition, repair of damaged intestinal epithelium, restoration of normal luminal bacterial populations, promotion of normal GI motility, and maintenance of normal immune functions (eg, both tolerance and protection from pathogens). The amount of food, its form, the frequency of feeding, and the composition of diet each have important effects on GI function and may be used to help ameliorate signs of GI disease. Although both nutrients and nonnutritional components of a diet are important to GI health, they also may cause or influence the development of GI pathology (eg, antibiotic responsive diarrhea, inflammatory bowel disease, dietary intolerance, or sensitivity and/or allergy). The appropriate diet may have a profound effect on intestinal recovery and successful management of chronic or severe GI disease.

Effect of Diets Differing in Fat Content on Chronic Diarrhea in Cats

“…Highly digestible, restricted‐fat diets have been advocated as appropriate for dogs with GI disease and diarrhea for many years 1–4 . Compared with protein and carbohydrate, fat is the most complex nutrient to digest and absorb.…”

“…Severe fat malabsorption is evident as steatorrhea, but fat malabsorption may occur in the absence of obvious steatorrhea. When fat digestion is incomplete, bacteria in the colon can ferment the undigested fat, producing potent secretagogues and proinflammatory compounds 3–5 . This results in a secretory diarrhea as well as intestinal inflammation.…”

Efficacy of an orally administered anti‐diarrheal probiotic paste (Pro‐Kolin Advanced) in dogs with acute diarrhea: A randomized, placebo‐controlled, double‐blinded clinical study

“…For example, the fat content of the placebo was slightly lower than that of the ADPP (39% and 42%, respectively). A low‐fat diet is commonly recommended in dogs with acute diarrhea because of the effect of dietary fat on gastrointestinal motility and the possibility that undigested fat in the colon could exacerbate diarrhea . However, the small difference in fat content between the ADPP and placebo was deemed unlikely to affect clinical outcome in the context of the total dietary intake of macronutrients.…”

Evaluation of a structured individualised protocol as a potential cost‐effective diagnostic and therapeutic approach to chronic diarrhoea in the dog

“…Commence limited antigen dietary trial (Zoran 2003;Mandigers et al 2010;Westermarck 2016) Commence concurrent fibre (Lecoindre & Gaschen 2011) Psyllium; ½ tablespoon daily toy breed, 1 tablespoon daily small breed, 2 tablespoons daily medium breed, 3 tablespoons daily large breed Commence probiotic trial (Sauter et al 2006;Rossi et al 2014;Schmitz et al 2015a,b) If faecal tests positive for organisms Weeks dogs with chronic idiopathic large bowel diarrhoea (Leib 2000). More recently, Volkmann and others reported a high prevalence of food-responsive enteropathies (47% of the affected dogs, with patients typically responding to an elimination diet) and antibiotic-responsive enteropathies (8% of the affected dogs, with patients typically responding to metronidazole) in a large series of dogs with chronic diarrhoea (Volkmann et al 2017) and Allenspach and others, in another large series of dogs with chronic enteropathies, reported a 64% prevalence of food-responsive diarrhoea and a 16% prevalence of antibiotic-responsive diarrhoea (Allenspach et al 2016).…”