JP2010017180A - Liquid diet preventing backflow from stomach to gullet - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a liquid diet requiring no cooking, capable of being administered within a short time, and causing neither backflow from the stomach to the gullet nor diarrhea and the like, and to provide a liquid diet contained in a bag, requiring no transfer to another bag in administration and capable of being hygienically connected to tube administration tubes such as a nasogastric tube or a gastrostomy tube. <P>SOLUTION: The liquid diet is composed of a nutritional composition and a thickener, wherein the nutritional composition and the thickener are mixed and administered in a liquid state or fluid state to turn the liquid diet semi-solidified in the stomach. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to a liquid food that is administered to elderly people, postoperative patients, enteral nutrition users, and the like by oral, tube, and gastrostomy catheters to prevent gastroesophageal reflux, diarrhea, and the like.

  There is a tube feeding method as a method for ingesting nutrients for elderly people and those who have difficulty in taking food orally due to injury or illness. The main gavage feeding methods include nasal gastric tube administration in which a tube is inserted into the stomach via the nasal cavity and administration via a gastrostomy. Since gastrostoma is less painful for patients and swallowing rehabilitation is easier, administration via gastrostoma has recently become widespread. A major problem with tube feeding of liquid nutrients is the backflow of the administered liquid food from the stomach to the esophagus, which can lead to esophagitis, pneumonia, and suffocation leading to death. Other problems include induction of diarrhea, rapid increase in blood glucose level, and leakage of nutrients from the fistula.

  In order to solve these problems, a commercially available semi-solidified nutrient that has been thickened in advance can be used, or agar, egg white, gelatin, etc. can be added to a normal liquid food to make it semi-solid to the extent of pudding or tea fumigation. There has been reported a method of using a material that has been semi-solidified prior to administration, such as a method of administering with a syringe after administration (see, for example, Patent Document 1). In addition, before or after administration of liquid food, as a food for preventing vomiting, a solution containing a thickener such as low methoxyl pectin is separately administered, and the thickener and liquid food ingredients in the anti-emetic food are mixed in the stomach. A method of increasing the viscosity by being reported has also been reported (for example, see Patent Document 2).

  However, for example, in the method described in Patent Document 1, liquid food and agar, egg white, etc. need to be mixed for cooking, cooking such as heat treatment, cooling treatment, etc. Furthermore, liquid food that is semi-solidified to the extent of pudding or steaming with tea The force is required to push out the tube, and it is difficult to pass through the tube at the time of tube administration via a gastrostomy catheter. Therefore, it takes time and effort of a nurse or a caregiver, and there is also a problem in terms of hygiene. In addition, in the method described in Patent Document 2, it is necessary to administer the anti-vomiting food separately from the liquid food, which takes time as compared with the administration of the liquid food alone. In addition to the problem that wounds are likely to deteriorate, when a liquid food is administered after administration of a vomiting preventive food containing a thickener such as rhomethoxyl pectin, the liquid food must be administered after the tube is washed once There was a problem that the administration operation was complicated and time-consuming. Therefore, there has been a demand for a liquid food that does not require labor, can be administered hygienically and in a short time, and can suppress gastroesophageal reflux or diarrhea.

JP 2004-26844 A Japanese Patent No. 3633942

  The object of the present invention is a liquid food that does not require cooking, can be administered in a short time, and does not have reflux or diarrhea from the stomach to the esophagus. It is to provide a liquid food in a container that can be connected hygienically to a tube or a tube for tube administration such as a gastrostomy catheter.

  As a result of intensive studies to solve the above-mentioned problems, the present inventors have obtained a fluidity until mixing with a nutritional composition and a thickener and then administering it to the stomach, making tube administration tubes easy. The present inventors have found that a liquid food that can be passed through the stomach and semi-solidified in the stomach can be prepared.

  That is, the liquid food according to the present invention comprises a nutritional composition and a thickening agent, and the liquidity or fluidity is fluid until the nutritional composition and the thickening agent are mixed and administered to the stomach. Further, after being administered to the stomach, it is semi-solidified in the stomach. Here, “semi-solidification” of a liquid food is a decrease in fluidity or loss of fluidity. Specifically, for example, a highly viscous fluid such as yoghurt, pudding or chawanmushi In this state, a certain shape is maintained.

  According to this liquid food, it is only necessary to mix the nutritional composition and the thickening agent, and cooking for semi-solidification is not required at the time of administration. And since it becomes semi-solid inside the stomach with a thickener, reflux from the stomach to the esophagus, diarrhea, etc. can be prevented. In addition, the nutritional composition and thickener are mixed and in liquid or fluid form until administered to the stomach. Because it is unnecessary, it does not take time and effort for nurses and caregivers, and it can be easily passed through the tube to the stomach, making it easy to administer via a gastrostomy catheter. is there. Furthermore, since the nutritional composition and the thickener can be mixed and administered, it does not take time and effort as in the case of administering anti-vomiting food separately from the liquid food, and the burden on the recipient is reduced. There is no problem that the wound is worsened by holding the sitting position, and there is no problem that it takes time and effort to clean the tube.

  In the liquid food of the present invention, it is preferable that the nutritional composition and the thickener are mixed before entering the stomach. As a result, the liquid food that has entered the stomach quickly becomes semi-solid, and reflux from the stomach to the esophagus, diarrhea, and the like are prevented.

  In the liquid food of the present invention, it is preferable that the nutritional composition and the thickener are mixed before administration. Thus, the liquid food reaches the stomach in a state where the nutritional composition and the thickener are well mixed, and quickly becomes semi-solid inside the stomach, thereby preventing reflux from the stomach to the esophagus, diarrhea and the like.

  In the liquid food of this invention, it is preferable that the said nutrition composition and a thickener are mixed just before administration. Thereby, since the time until administration is completed at the same time as the nutritional composition and the thickener are further mixed is fluid, it is possible to easily pass a tube such as a gastrostomy catheter. By semi-solidifying inside the stomach, reflux from the stomach to the esophagus and diarrhea are prevented.

  The liquid food of the present invention can of course be administered from the mouth, but because of its high fluidity, it is administered via a nasogastric tube in which a tube is inserted into the stomach via the nasal cavity or via a gastrostomy. It is suitable for tube administration. Among tube administration, it is suitable as a liquid food administered through a gastrostoma such as a gastrostomy catheter.

  In the liquid food of this invention, it is preferable that the said thickener is gellan gum. By mixing a thickener as described above with the nutritional composition, the liquid food becomes semi-solid inside the stomach, so it easily passes through the tube to reach the stomach during tube administration, and from the stomach to the esophagus. Reflux and diarrhea are well prevented. The gellan gum is preferable because it thickens well by gastric acid, and among the gellan gums, deacylated gellan gum is more preferable because it thickens well by gastric acid and makes the liquid food semi-solid.

  In the liquid food, it is preferable to contain 0.01 to 20% by weight of a thickener in the whole liquid food, particularly 0.1 to 1.1% by weight when gellan gum is used. Is more preferable. By containing the thickener in the above range, it is possible to increase the viscosity well in the stomach and to prevent the backflow of the liquid food from the stomach to the esophagus. The nutritional composition in this case is not particularly limited, and includes enteral nutrients that are pharmaceuticals and liquid foods that are foods, concentrated liquid foods, and mixer foods. Moreover, you may use the component of what is generally distribute | circulating.

  In a preferred embodiment of the liquid food of the present invention, the nutritional composition and the thickening agent are provided with a connection port to a tube for tube administration inserted into the body of a patient, and a plurality of chambers partitioned by a partition wall. The different chambers of the container it has are filled separately. According to this liquid food, the nutritional composition and the thickener can be mixed and administered simply by connecting the container to the tube administration tube, and the administration is not time-consuming.

  It is preferable that the container includes a mixing unit that mixes the nutrient composition and the thickener. Thereby, the effort which mixes the said nutrient composition and a thickener can be saved.

  Although the said mixing means can be provided in various parts of a liquid food container, it can be provided between each said chambers, for example. Thereby, it can inject | pour into the tube for tube | pipe administration via the said connection port in the state with which the said nutrient composition with which each chamber was filled, and the thickener were mixed.

  The mixing means may be provided in the connection port. Thereby, the said nutrient composition and thickener with which each chamber was filled can be well mixed in the said connection port, and can be inject | poured into the tube for tube administration.

  By connecting the connection port of the container to a tube for tube administration, each chamber may be communicated to mix the nutrient composition and the thickener. Thereby, it can prevent that a nutritional composition and a thickener contact before connecting to the tube for tube administration, and a liquid food thickens before administration and tube passage property falls.

  The container may be provided with an extruding means for extruding the nutrient composition and the thickener from the connection port in a mixed state. Accordingly, when necessary, the time required for administration can be shortened by increasing the rate of liquid food extraction from the container by the extrusion means.

  As a liquid food provided with the extruding means, each chamber of the container is composed of a deformable flexible material or elastic material, and the nutrient composition and the thickener are pushed out of each chamber by pressurization. Also good. Thereby, a nutrient composition and a thickener can be extruded from a container by simple operation which only pressurizes a container.

  In the liquid food of the present invention, the nutrient composition and the thickener may be sterilized by heating or heat and pressure sterilization after filling each chamber, or may be sterilized by heat or pressure and sterilization. It may be filled. Thereby, a sanitary liquid food can be provided.

  In the liquid food, it is preferable that the nutrient composition and the thickener are individually sterilized by heating or sterilization by heating and then filled in each chamber. Thereby, the liquid food contained in the container as described above can be easily produced, and each component can be sterilized under the optimum conditions, and thickening of the liquid food before administration can be prevented.

  As described above, according to the present invention, there is no need for cooking for semi-solidization at the time of administration, administration is easy, administration is possible in a short time, and there is no reflux or diarrhea from the stomach to the esophagus. To provide a liquid food contained in a container that can be hygienically connected to a tube for tube administration such as a nasogastric tube or a gastrostomy catheter without the need to transfer the container for administration. Can do.

It is explanatory drawing which shows one example of the use condition of the liquid food which concerns on this invention. It is explanatory drawing which shows the other example of the use condition of the liquid food which concerns on this invention. Embodiment of the liquid food which concerns on this invention is shown, (a) is a front view, (b) is a partial perspective view. Embodiment of the liquid food which concerns on this invention is shown, (a) is a front view, (b) is a partial cross section figure. Embodiment of the liquid food which concerns on this invention is shown, (a) is sectional drawing, (b) is a partial perspective view. It is sectional drawing which shows embodiment of the liquid food which concerns on this invention.

  Hereinafter, the present invention will be described in more detail. In general, "liquid food" is a fluid nutritional composition administered through a nasogastric tube or a gastrostomy catheter. Including liquid food and mixer food. Furthermore, water administered through a nasogastric tube or gastrostomy catheter, soft drinks, confectionery, nasogastric tube washing water, and catheter washing water can also be included in this category. As the nutritional composition in the present invention, what is generally referred to as “liquid food” can be used as described above, and commercially available products such as EMSURE LIQUID (registered trademark) manufactured by Meiji Dairies Co., Ltd. and Morinaga Milk Industry MA-7 (M7, sold by Kurinico Co., Ltd.) manufactured by Co., Ltd. can be used.

  The liquid food of the present invention is characterized in that a thickener is mixed with a general liquid food or a nutritional composition contained therein, and after mixing, the liquid food is semi-solidified inside the stomach. There is no particular limitation on the principle that the liquid food becomes semi-solid inside the stomach. However, from the viewpoint of making the liquid food semi-solid satisfactorily inside the stomach, it is preferable that the liquid food becomes semi-solid by mixing the gastric juice with the gastric juice inside the stomach.

  The thickener of the present invention is not particularly limited as long as it is semi-solidified in the stomach after being mixed with the nutritional composition. Among them, a thickener that gels under acidity due to the presence of gastric acid is preferable from the viewpoint of making the liquid food semi-solid satisfactorily inside the stomach. As the thickener, at least one selected from the group consisting of gellan gum, kappa carrageenan, iota carrageenan, lambda carrageenan, pectin, xanthan gum, locust bean gum, alginic acid, sodium alginate, gum arabic, collagen, gelatin and polygamma glutamic acid. Can be used. Among these thickeners, gellan gum is preferable from the viewpoint of favorably thickening the liquid food under acidity due to the presence of gastric acid.

  The gellan gum is a linear polysaccharide composed of repeating units of tetrasaccharides of glucose, glucuronic acid, glucose and rhamnose produced by fermentation of Pseudomonas elodea. Further, among gellan gums, deacylated gellan gum is preferable from the viewpoint of having fluidity until entering the stomach and making the liquid food semi-solid in the stomach after administration. Furthermore, among them, Gelup (registered trademark) KS (F) from San-Ei Gen FFI Co., Ltd. is more preferable.

  The thickener as described above may be mixed with powdered nutritional composition, or mixed with a thickening agent solution in which the thickener is dissolved in liquid and administered. You can also. However, it is preferable to mix with the nutrient composition in the state of an aqueous solution from the viewpoint of the flow of the liquid food, that is, the permeability of the tube for tube administration, and the good mixing with the nutrition composition.

  In the present invention, the appropriate amount of the thickener content varies depending on the type of the thickener, but is generally preferably 0.01 to 20% by weight (solid content) in the whole liquid food. If it is less than 0.01% by weight, the thickening in the stomach is insufficient and the gas may flow back from the stomach to the esophagus. On the other hand, if it is more than 20% by weight, the stomach may be felt heavy or uncomfortable. Furthermore, gellan gum is preferably 0.1 to 1.1% by weight from the viewpoint of easily passing through a tube for tube administration and making it semi-solid well in the stomach.

  In addition, the time required for administering the liquid food of the present invention to the stomach is not particularly limited, and may be determined in consideration of the patient's condition and the work burden of the caregiver. However, it has fluidity until it enters the stomach, and from the viewpoint of satisfactorily solidifying the liquid food in the stomach, the time is after the nutritional composition and the thickener are mixed. It is preferably within 3 hours, more preferably within 2 hours, further preferably within 1 hour, even more preferably within 30 minutes, and particularly preferably within 15 minutes.

  According to the liquid food of the present invention as described above, the nutritional composition and the thickener are mixed before entering the stomach and further semi-solidified in the stomach, thereby suppressing the backflow from the stomach to the esophagus. As described above, in the present invention, semi-solidification means a decrease in fluidity or loss of fluidity. Specifically, for example, a highly viscous fluid such as yoghurt, pudding, and steamed tea It is a state that holds a certain shape. Such a shape is an intermediate substance form between solid and liquid, and is a state of a substance that swells at room temperature but does not dissolve but easily disintegrates by applying force and exhibits fluidity. Along with semi-solidification, the fluidity of the stomach contents decreases, which is effective against aspiration pneumonia and vomiting due to a decrease in reflux from the stomach to the esophagus. In gastrostomy cases, fistula permeability is reduced, which is effective in suppressing leakage of liquid food to unfavorable locations. Furthermore, the liquid food can be administered in a short time due to the decrease in vomiting due to semi-solidification. Furthermore, along with the semi-solidification, the rate of excretion of stomach contents to the intestine is reduced, diarrhea is suppressed, and a rapid increase in blood glucose level is also suppressed.

  The liquid food of the present invention is administered in the form of (1) a nutrient composition and a thickener are separately introduced into the stomach and mixed with gastric juice for the first time, and (2) introduced into the stomach. (3) When administered into the stomach, that is, a tube such as a nasogastric tube or gastrostomy catheter A form in which the nutritional composition and the thickener are already mixed at the time of introduction into the administration tube and the mixture is mixed with the gastric juice inside the stomach can be employed. Among these three dosage forms, the forms (2) and (3), particularly the form (3) are mixed with both a nutritional composition and a thickener, and a nasogastric tube or stomach It is preferable because it can be introduced into a tube for tube administration such as an acupuncture catheter, and administration does not take time.

  As a preferred embodiment of the present invention, a nutritional composition and a thickener are used using a container having a connection port for tube administration or gastrostomy administration and having two or more chambers partitioned by a partition wall. Are filled in separate chambers, the dosage forms (1) to (3), particularly the dosage forms (2) and (3), can be easily realized. It is also possible to fill other chambers with other solutions such as catheter wash water or replenishment water. When two or more kinds of contents are filled in a container having a plurality of chambers as described above, the filling ratio of the contents is not particularly limited, and the total amount and administration of the nutritional composition, thickener, and other components What is necessary is just to determine suitably in the range with which the effect of this invention is acquired from a viewpoint, such as time and the burden on a patient. In addition, even when the filling ratio of each component is different, administration after mixing the nutrition composition and thickener, or by adjusting the administration rate of the nutrition composition and thickener, A liquid food that is fluid when passing through a tube for tube administration from the start to the end of administration and semi-solidifies in the stomach can be provided.

  Further, in any of the above forms (1) to (3), a container having a connection port for tube administration or gastrostomy administration and having two or more plural chambers partitioned by a partition wall Each chamber can be used as a liquid food that has been filled after being heat sterilized or heat and pressure sterilized. In addition, when the container is filled with the nutritional composition and / or the thickener, it is preferable that the container is heat sterilized or heat sterilized prior to or after filling. Here, heat sterilization or heat and pressure sterilization is preferably to pressurize to 0.1 MPa to 1 MPa and perform pressure heat sterilization treatment at 100 ° C. to 160 ° C. for 1 second to 60 minutes. Heat treatment such as pressure heat sterilization (retort sterilization), energization heat sterilization, and microwave heat sterilization, which are employed in the food industry and the like as a simple sterilization treatment, can be used. Pressure heat sterilization (retort sterilization) is preferable from the standpoints of sterilization effect, product quality maintenance, product safety ensuring, ease of use, and ease of maintenance.

  The material and form of the liquid food container of the present invention are not particularly limited, and for example, a brick type (paper), a transparent pouch (polyethylene bag), an aluminum pouch bag, and the like are preferably used. In the form (3), a liquid food containing a nutritional composition and a thickener may be stored in one container, and there are a plurality of (for example, two) chambers with a partition inside the container. The nutrient composition is stored in one (one) chamber, and the thickener is stored in the other (other) chamber. The connection port is connected to the tube administration tube. It may be a structure in which both components are combined and mixed at the same time as they leave.

  The liquid food and the method of using the same according to the present invention will be described in more detail based on the embodiment of the liquid food in various containers shown in the drawings. The liquid foods in the container shown in the figure are all in the form (3), that is, when administered into the stomach, that is, when introduced into a tube for tube administration such as a nasogastric tube or a gastrostomy catheter. The nutrient composition and the thickener are already mixed, and the mixture is used in the form of being mixed with gastric juice in the stomach.

  First, FIG. 1 shows that the liquid food of the present invention contained in a container is applied to the stomach 200 of an elderly person or a person who suffers from oral intake of food due to injury or illness. The method of administering via the catheter 100 is illustrated. The gastrostomy catheter 100 penetrates the gastric wall 201 and the abdominal wall 202 and is fixed by an intragastric fixation plate (which may be a balloon) and an external fixation plate 102. The gastrostomy catheter 100 includes a connector 104 having two mixed injection ports 105 and 106 in the illustrated example at the distal end of a tube 103 extending from the extracorporeal fixation plate 102. The liquid food is contained in the container 1, and the connection port 2 is connected to one mixing port 105 of the gastrostomy catheter 100. 2 is an example in which an infusion tube 110 is further added as a tube for tube administration to the gastrostomy catheter 100, and the connection port 2 of the container 1 is connected to the connector 111 of the infusion tube 110.

  In addition, the illustrated roller clamp 112 and other flow rate adjusting means may be provided in the middle of the infusion tube 110. 1 and 2 show a tube-type gastrostomy catheter having the tube 103 as a tube for tube administration, but a button-type gastrostomy catheter without a tube may be used. In that case, for example, an infusion tube 110 as shown in FIG. 2 can be directly connected to the button-type gastrostomy catheter. Moreover, it is also possible to connect and administer the container 1 containing the liquid food to a nasogastric tube or other tube for tube administration instead of the gastrostomy catheter as shown in the figure. Moreover, the structure of each connection part including the connection part of the connection port 2 of the container 1 and the mixed injection port 105 of the gastrostomy catheter 100 is a luer slip method that fits by frictional force, and screwing is added to the frictional force. Various types of connection methods such as a luer lock method can be employed.

  FIG. 3a shows one of the liquid food embodiments of the present invention. In this embodiment, for example, the interior of the container 1 made of a transparent pouch made of polyethylene, an aluminum pouch bag, or the like is placed above and below the first chamber 4 and the second chamber 5 by the partition wall 3 made of a weak seal portion as a removable separator. The first chamber 4 is partitioned into two chambers, and communicates with an extraction hole 6 that opens at the tip of the connection port 2 to the tube administration tube. 3a shows the container 1 in a use posture with the connection port 2 below, but when storing and transporting until use, the connection port 2 faces upward and a pour hole with a cap (not shown). 6 is sealed. Moreover, although the container 1 in the illustrated example is partitioned by one partition 3, the position at which the two chambers are partitioned by the partition 3 is not particularly limited. Moreover, although it is divided into two chambers by one partition 3, it is divided into three or more chambers by two or more partitions, and the third component other than the nutrient composition and the thickener is included. Also good.

  In the container 1, for example, the first chamber 4 is filled with a liquid nutrient composition, and the second chamber 5 is filled with a thickener aqueous solution. Is removed, the first and second chambers 4 and 5 communicate with each other, and the nutrient composition and the thickener aqueous solution filled in each chamber are mixed in the container 1. That is, the partition wall 3 formed of a weak seal portion functions as a mixing means as a through or peelable separator provided between the first and second chambers 4 and 5.

  Moreover, what is shown to FIG. 3b is a perspective view of the principal part which shows other embodiment of the connection port 2 of the said container 1. FIG. Here, a turbulent flow plate 7 as a mixing means is provided on the inner surface of the extraction hole 6 communicating with the first chamber 4, and the first and second chambers 4 and 5 are separately filled and the partition 3 is peeled off. When the mixed nutritional composition and the aqueous solution of the thickener are introduced into the tube for tube administration such as a nasogastric tube or a gastrostomy catheter through the extraction hole 6, turbulent flow It is further mixed by the plate 7. The shape, number, inclination angle, and the like of the turbulent flow plate 7 as the mixing means are not limited to those shown in the drawings, and various forms such as an inclined shape, a cross shape, or a spiral shape can be adopted.

  Next, FIG. 4a shows a liquid food container of another embodiment. The liquid food container 11 is formed of, for example, a transparent pouch, an aluminum pouch bag, and the like, similar to the container 1 of the above-described embodiment, but the interior of the container 11 is separated by a partition wall 13 so that the first chamber 14 and the second chamber 15 are It is divided into right and left instead of up and down. The partition wall 13 is not a weak seal portion, and the first and second chambers 14 and 15 are partitioned by the partition wall 13 so as not to communicate with each other. Each of the first and second chambers 14 and 15 is provided with neck portions 18a and 18b having opening holes 16a and 16b opened at the tips, and these neck portions 18a and 18b are two mixed injections of the branched connecting pipe 12. The ports 19a and 19b are detachably provided. As shown in FIG. 4b, each branch hole 12a, 12b of the branch connection tube 12 opened to the mixed injection port 19a, 19b is poured into a tube for tube administration such as a nasogastric tube or a gastrostomy catheter. The nutritional composition filled in the first chamber 14 and the thickener aqueous solution filled in the second chamber 15 flow into the injection hole 16 through the branch holes 12a and 12b, It is mixed and introduced into the stomach via a tube for tube administration such as a nasogastric tube or a gastrostomy catheter. FIG. 4a also shows the liquid food container 11 in use with the spouts 16a and 16b and the branch connection pipe 12 below, but the branch connection pipe 12 is separated during storage and transportation. In this state, the extraction holes 16a and 16b of the necks 18a and 18b of the chambers 14 and 15 are sealed with caps or the like. In addition, after branching pipes 12a and 16b are sealed, branching connecting pipe 12 is inserted, and in use, once branching connecting pipe 12 is removed and the seal is removed, then branching connecting pipe 12 is again used. It may be a structure to insert. Further, when the volume of the thickener aqueous solution and the nutrient composition filled in the first chamber 14 and the second chamber 15 is not equal, the spouts 16a and 16b are arranged so that the nutrient composition and the thickener solution are uniformly mixed. Means for correcting the difference in volume, such as adjusting the diameter, can be provided.

  4b is a cross-sectional view showing another embodiment of the branch connection pipe 12 of the liquid food container 11, and in this embodiment, the branch holes 12a and 12b extending from the mixed injection ports 19a and 19b join together. A turbulent flow plate 17 as a mixing means is provided on the inner surface of the dispensing hole 16, and the nutrient composition and the thickener aqueous solution filled in the first and second chambers 14 and 15 of the container 11 are branched. Further, the mixture is further mixed by the turbulent flow plate 17 when being introduced into a tube for tube administration such as a nasogastric tube or a gastrostomy catheter through the extraction hole 16 of the tube-shaped connecting tube 12. The shape, number, inclination angle, etc. of the intruding plate 17 as the mixing means are not limited to those shown in the figure, and may be provided inclined or crossed. In addition, when the volume of the thickener aqueous solution and the nutrient composition filled in the first chamber 14 and the second chamber 15 are not equal, the branch holes 12a and 12b are mixed so that the nutrient composition and the thickener solution are uniformly mixed. Means for correcting the difference in volume, such as adjusting the diameter, can be provided.

  FIG. 5 a is a cross-sectional view of a liquid food container 21 of still another embodiment. The liquid food container 21 is made of, for example, a container made of synthetic resin such as polypropylene or polyethylene, a transparent pouch, an aluminum pouch bag, and the like. 25 left and right two chambers are partitioned so as not to communicate. The neck portion 28 of the container 21 is provided with dispensing holes 26 a and 26 b that communicate with the first and second chambers 24 and 25 and are independent of each other to form a connection port 22. As shown in FIG. 5b, a slit 27 for cutting is provided on the outer peripheral surface of the neck portion 28 on the base end side from the tip of each of the extraction holes 26a, 26b, and the tip portion 28a ahead of the slit 27 is cut off. Or it can pour out in the state which can mix the nutrient composition and the thickener aqueous solution with which the 1st chamber 24 and the 2nd chamber 25 were filled very easily by folding. In addition, when the volume of the thickener aqueous solution and the nutrient composition filled in the first chamber 24 and the second chamber 25 are not equal, the dispensing holes 26a and 26b so that the nutrient composition and the thickener solution are uniformly mixed. Means for correcting the difference in volume can be provided, such as adjusting the diameter.

  FIG. 6 shows a liquid food container 31 of still another embodiment. The liquid food container 31 is made of, for example, a synthetic resin such as polypropylene or polyethylene, is made of a flexible or elastic material that can be deformed, and has a bellows shape as shown in the figure, so that the contents can be pushed out by pressurization. Is formed. The inside of the container 31 is partitioned into two upper and lower chambers, a first chamber 34 and a second chamber 35, by a partition wall 33 made of a penetrable separator, and the first chamber 34 is a connection port to a tube administration tube. It communicates with an extraction hole 36 opened at the tip of 32. 6 shows the container 31 in use in which the connection port 32 is below, but is sealed with a cap 37 with the connection port 32 facing upward during storage and transportation. The container 31 is also partitioned into two chambers by one partition 33, but may be partitioned into three or more chambers by two or more partitions.

  A container 31 shown in FIG. 6 is filled with a liquid nutritional composition in one of two chambers partitioned by a partition wall 33, for example, the lower first chamber 34 in the figure, while the upper side in the figure. When the second chamber 35 is filled with the thickener aqueous solution and the partition wall 33 is broken, the first and second chambers 34 and 35 are communicated with each other, and the nutrition composition and the thickener aqueous solution filled in each chamber are used. Are mixed in the container 31. That is, the partition wall 33 functions as a mixing means as a pierceable separator provided between the first and second chambers 34 and 35. Further, the liquid food container 31 is formed in a bellows shape by a flexible material or an elastic material, and the time required for administration by increasing the dispensing speed from the dispensing hole 36 by pressurizing the container 31 by hand. Can be shortened.

  At present, the main usage is that the liquid food is introduced through a tube for tube administration such as a nasogastric tube or a gastrostomy catheter. Therefore, in any of the forms (1) to (3), a syringe, a peristaltic pump, or a storage container can be administered to a nasogastric tube tube and / or a gastrostomy catheter. It preferably has fluidity that can be administered by crushing by hand. In this regard, the liquid food of the present invention is liquid or fluid when administered in a mixture of a nutritional composition and a thickener, and therefore can be easily passed through a tube for tube administration such as a nasogastric tube or a gastrostomy catheter. Can be introduced into the stomach and semi-solidified in the stomach to prevent reflux from the stomach to the esophagus, diarrhea and the like.

  Furthermore, like the liquid food according to each of the above-described embodiments, the nutritional composition and the thickener are partitioned by the partition walls 3, 13, 23, 33 in one container 1, 11, 21, 31, etc. Moreover, the trouble of liquid food administration can be reduced by filling the plurality of chambers separately.

  Hereinafter, the present invention will be described more specifically with reference to examples. However, the present invention is not limited to these examples. In addition, the thickener and liquid food to be used can be purchased from a market supplier and used.

Example 1
(1) Preparation of liquid food containing thickener As deacyl gellan gum, 1 g of Gel-up (registered trademark) KS (F) (gellan gum content 42%) of Saneigen FFI Co., Ltd. Fresh water warmed to 80 ° C. was added and dissolved so that the final volume became 100 ml, and a 1 wt% gel-up KS solution (gellan gum concentration 0.42 wt%) was prepared.
As a nutritional composition, Ensure Liquid (registered trademark) strawberry flavor of Meiji Dairies Co., Ltd. was heated to 30 ° C., and 20 ml was dispensed into a screw cap type tube (50 ml capacity). 10 ml of the gel-up KS solution was added thereto, and gently mixed while tumbling the tube to prepare a gellan gum-containing liquid food.
The gellan gum-containing liquid food obtained was not semi-solid as it was, but could be easily passed through a 15 Fr feeding tube by a method such as manually pressing a syringe, a peristaltic pump, or a container.
(2) Solidification test Artificial gastric juice (pH 1.2, sodium chloride 2.0 g / L, hydrochloric acid 7.0 mL) prepared based on the disintegration test method of the Japanese Pharmacopoeia in a screw cap type tube (50 ml capacity). / L) 1.8 ml was dispensed. When 3.0 ml of the gellan gum-containing liquid food was added thereto, the liquid food was semi-solidified to the extent of purine.

(Comparative Example 1)
Since Ensure Liquid (registered trademark) strawberry flavor of Meiji Dairies Co., Ltd. was heated to 30 ° C., 20 ml was dispensed into a screw cap type tube (50 ml capacity). A control liquid food was prepared by adding 10 ml of fresh water and mixing gently while inverting the tube.
As described above, 1.8 ml of artificial gastric juice prepared based on the disintegration test method of the Japanese Pharmacopoeia was dispensed into a screw cap type tube (50 ml capacity). When 3.0 ml of the control liquid food was added thereto, the liquid food remained fluid without being semi-solidified.

(Example 2)
(1) Preparation of liquid food containing thickener As deacylated gellan gum, 2 g of Gel-up (registered trademark) KS (F) (gellan gum content 42%) from San-Ei Gen FFI Co., Ltd. Fresh water warmed to 80 ° C. was added and dissolved to a final volume of 100 ml to prepare a 2 wt% gel-up KS solution (gellan gum concentration 0.84 wt%).
As a nutritional composition, MA-7 manufactured by Morinaga Milk Industry Co., Ltd. (M7, sold by Clinico Co., Ltd.) was heated to 30 ° C., and 15 ml was dispensed into a screw cap type tube (50 ml capacity). 15 ml of the gel-up KS solution was added thereto, and gently mixed while tumbling the tube to prepare a gellan gum-containing liquid food.
The gellan gum-containing liquid food obtained was not semi-solid as it was, but could be easily passed through a 15 Fr feeding tube by a method such as manually pressing a syringe, a peristaltic pump, or a container.
(2) Solidification test Artificial gastric juice (pH 1.2, sodium chloride 2.0 g / L, hydrochloric acid 7.0 mL) prepared based on the disintegration test method of the Japanese Pharmacopoeia in a screw cap type tube (50 ml capacity). / L) 1.8 ml was dispensed. When 3.0 ml of the gellan gum-containing liquid food was added thereto, the liquid food was semi-solidified to the extent of purine.

(Comparative Example 2)
MA-7 manufactured by Morinaga Milk Industry Co., Ltd. (M7, sold by Clinico Co., Ltd.) was heated to 30 ° C., and 15 ml was dispensed into a screw cap type tube (50 ml capacity). A control liquid food was prepared by adding 15 ml of fresh water and mixing gently while inverting the tube.
As described above, 1.8 ml of artificial gastric juice prepared based on the disintegration test method of the Japanese Pharmacopoeia was dispensed into a screw cap type tube (50 ml capacity). When 3.0 ml of the control liquid food was added thereto, the liquid food remained fluid without being semi-solidified.

(Examples 3 to 16)
The liquid food which changed the addition amount of the gellan gum with respect to a nutrition composition was prepared, and the following tests were done.
(Test method)
As a deacylated gellan gum, 80 of Gelei (registered trademark) KS (F) (gellan gum content 42%; in Tables 1 and 2 below, abbreviated as KS) manufactured by San-Ei Gen FFI Co., Ltd. A gel-up KS aqueous solution of 0.6 to 2.5 wt% (gellan gum concentration of 0.25 to 1.18 wt%; in Tables 1 and 2 below, abbreviated as KS solution) ) Was prepared and kept at 25 ° C.
As a nutritional composition, MA-7 manufactured by Morinaga Milk Industry Co., Ltd. (M7, sold by Clinico Co., Ltd.) kept at 25 ° C. was used. A total of 10 ml of MA-7 and gel-up KS solution were dispensed into a screw cap type tube (50 ml capacity) so that the composition ratios shown in Tables 1 and 2 below were obtained. A gellan gum-containing liquid food was prepared by gently mixing while tumbling the tube.

The obtained gellan gum-containing liquid food was stored at 25 ° C. for 15 minutes, and the fluidity of the gellan gum-containing liquid food after storage was visually confirmed.
Further, 1.8 ml of artificial gastric fluid (pH 1.2, sodium chloride 2.0 g / L, hydrochloric acid 7.0 mL / L) heated to 37 ° C. was dispensed into a screw cap type tube (15 ml capacity). To this, 3 ml of a mixture of MA-7 and gel-up KS solution so as to have the composition ratio described in Tables 1 and 2 below is added, and the degree of semisolidification of the liquid food (semisolidity) is determined. It was observed visually.

(Test results)
The evaluation results of the test are shown in Tables 1 and 2. In Tables 1 and 2, “◯” indicates that the liquid food in which the nutritional composition (MA-7) and the thickener solution (KS solution) were mixed had fluidity even after 15 minutes of mixing. “▲” indicates that the liquid food is semi-solidified into yogurt when added to the artificial gastric juice, and “●” indicates that the liquid food is semi-solidified into purine when added to the artificial gastric juice. As shown in Tables 1 and 2, when the gel-up KS aqueous solution is blended so that the gellan gum concentration is 0.13 to 1.06 wt% with respect to the whole liquid food, the nutritional composition and the gellan gum solution are mixed. After that, although it had fluidity for 15 minutes, it was confirmed that the liquid food became semi-solid by mixing with artificial gastric juice. That is, after mixing with the nutritional composition, the liquid food can be easily administered by blending the gel-up KS solution so that the gellan gum is 0.1 to 1.1 wt% with respect to the whole liquid food. In addition, since gellan gum gels when exposed to gastric acid after administration, it is considered that the liquid food becomes semi-solid inside the stomach and can prevent reflux from the stomach to the esophagus, diarrhea, and the like.

1, 11, 21, 31 Liquid food container 2, 12, 22, 32 Connection port (pipe)
3, 13, 23, 33 Partition (separator)
4, 14, 24, 34 First chamber 5, 15, 25, 35 Second chamber 6, 16, 16a, 16b, 26a, 26b, 36 Outlet hole 7, 17 Turbulent plate 18, 28 Neck portion 19a, 19b Mixed injection Mouth 27 slit 100 gastrostomy catheter 101 intragastric fixation plate 102 extracorporeal fixation plate 103 tube 104 connector 105, 106 co-infusion port 110 infusion tube 111 connector 112 roller clamp 200 stomach 201 gastric wall 202 abdominal wall

Claims (19)

  A liquid food comprising a nutritional composition and a thickening agent, wherein the nutritional composition and the thickening agent are mixed, administered in liquid or fluid form, and semi-solidified in the stomach.   The liquid food according to claim 1, wherein the nutritional composition and the thickener are mixed before entering the stomach.   The liquid food according to claim 1, wherein the nutritional composition and the thickener are mixed before administration.   The liquid food according to claim 3, wherein the nutritional composition and the thickener are mixed immediately before administration.   The liquid food according to any one of claims 1 to 4, which is administered into the stomach through a tube.   The liquid food according to claim 5, which is administered by tube through a gastrostomy.   The liquid food according to any one of claims 1 to 6, wherein the thickener is gellan gum.   The liquid food according to claim 7, wherein the gellan gum is deacylated gellan gum.   The liquid food according to claim 7, wherein the gellan gum is Gelup (registered trademark) KS (F).   The liquid food according to any one of claims 7 to 9, wherein the gellan gum concentration is 0.01 to 20% by weight in the whole liquid food after mixing with the nutritional composition.   The liquid food according to any one of claims 7 to 9, wherein the gellan gum concentration is 0.1 to 1.1% by weight in the whole liquid food after mixing with the nutritional composition.   The said nutrient composition and thickener are each filled in each chamber of the container which has a connection port to the tube for tube administration, and has several chambers divided by the partition. Liquid food according to crab.   The liquid food of Claim 12 with which the said container is equipped with the mixing means which mixes the said nutrient composition and a thickener.   The liquid food according to claim 13, wherein the mixing means is provided between the chambers.   The liquid food according to claim 14, wherein the mixing means includes a through or removable separator provided between the chambers.   The liquid food according to claim 13, wherein the mixing means is provided in a connection port.   The liquid food according to any one of claims 12 to 16, wherein each of the chambers is communicated by connecting the connection port of the container to a tube for tube administration so that the nutrient composition and the thickener are mixed.   The liquid food according to any one of claims 12 to 17, wherein the container includes an extruding means for extruding the nutrient composition and the thickener from a connection port in a mixed state. The liquid food according to claim 18, wherein each chamber of the container is made of a deformable flexible material or an elastic material, and the nutrient composition and the thickener are pushed out of each chamber by pressurization.

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