JP5732738B2 - Method for reducing or preventing vomiting, method for thickening enteral nutrients, method for supplying nutrition, and enteral nutrient set - Google Patents

Description

  The present invention relates to a method for reducing or preventing vomiting caused by tube administration when the enteral nutrient is administered to a tube feeding recipient, to the extent that vomiting caused by tube administration can be reduced or prevented. The present invention relates to a method for increasing the viscosity of intestinal nutrients, a method for supplying nutrition while reducing or preventing emesis caused by tube administration, and an enteral nutrient set that can reduce or prevent emesis caused by tube administration.

  Some elderly people are unable or insufficient to take food and beverages orally. For such persons, enteral nutrients are administered using a tube that passes from the nose or fistula formed in the abdomen into the digestive organs (specifically, in the stomach or duodenum) ( Tube feeding). However, in many people who need tube feeding, the motility of the intestinal tract is reduced due to long-term bedridden, etc., which causes the problem of vomiting enteral nutrients administered into the digestive tract. there were.

  In order to reduce or prevent vomiting caused by tube administration of such enteral nutrients, a low viscosity that is combined with the calcium content in enteral nutrients before or after the tube administration of enteral nutrients. It has been proposed to administer an anti-vomiting food containing methoxyl pectin (Patent Document 1). In addition, in one serving (200 to 400 kcal) of such an enteral nutrient, 1 / day of the calcium dietary intake standard amount (about 700 mg / day) required for maintaining health (Non-patent Document 1). About twice to twice the amount of calcium is blended.

No. 00-13529

“Japanese food intake standards (2005 edition)”, formulated by the Ministry of Health, Labor and Welfare

  However, even when the anti-emetic food of Patent Document 1 is combined with an enteral nutrient containing a sufficient amount of calcium for maintaining health per serving, vomiting may not be sufficiently reduced or prevented.

  In the present invention, an enteral nutrient that causes vomiting due to tube administration even when using an aqueous solution of low methoxyl pectin for preventing vomiting described in Patent Document 1 is administered to a recipient of tube feeding. The purpose is to reduce or prevent vomiting caused by tube administration when administered by tube.

  The present inventor cannot reduce or prevent vomiting even when combined with an enteral nutrient containing a sufficient amount of calcium for maintaining health and a low-methoxyl pectin aqueous solution that is an anti-emetic agent disclosed in Patent Document 1. To investigate the reason, we focused on the calcium ion content, not the calcium content in the composition of enteral nutrients, and studied the relationship between the calcium ion content of many commercially available enteral nutrients and the occurrence of vomiting. As a result, even if a low methoxyl pectin aqueous solution is used, it is difficult to reduce or prevent vomiting if the amount of calcium ions in a single enteral nutrient is too small, and the amount of such calcium ions is small. In the case where it passes, it discovered that the objective of this invention could be achieved by mixing a calcium ion supply agent with the commercially available enteral nutrient of a completed formulation, and completed this invention.

  That is, the present invention is a method for reducing or preventing vomiting caused by tube administration when the enteral nutrient having a calcium ion concentration of less than 10 ppm is administered to a tube feeding recipient. Low methoxyl pectin that exerts a thickening effect by calcium ions in enteral nutrients before or after tube administration of the mixture when calcium ion supply agent is mixed with the agent and the obtained mixture is administered by tube Provided is a method for reducing or preventing vomiting by administering an aqueous solution by tube.

  Moreover, the present invention, as another aspect, is a method for increasing the viscosity of enteral nutrients administered by tube administration with a calcium ion concentration of less than 10 ppm to such an extent that vomiting due to tube administration can be reduced or prevented, When a calcium ion supply agent is mixed with an enteral nutrient and the resulting mixture is administered by tube, a thickening effect is exerted by calcium ions in the enteral nutrient before or after the tube administration of the mixture. Provided is a method for thickening enteral nutrients by tube administration of an aqueous solution of low methoxyl pectin.

  Furthermore, the present invention provides, as another aspect, reducing vomiting caused by tube administration when feeding an enteral nutrition recipient by tube administration of an enteral nutrient having a calcium ion concentration of less than 10 ppm. A method of feeding nutrition while preventing, when a calcium ion supply agent is mixed with an enteral nutrient, and when the obtained mixture is administered by tube, before or after the tube administration of the mixture, enteral nutrient Provided is a nutritional supplementation method in which a low methoxyl pectin aqueous solution that exhibits a thickening effect by calcium ions therein is administered by tube.

Further, the present invention is an enteral nutrient set that can reduce or prevent vomiting caused by tube administration to enteral nutrition recipients of enteral nutrients having a calcium ion concentration of less than 10 ppm,
Enteral nutrients with a calcium ion concentration of less than 10 ppm,
A low methoxyl pectin aqueous solution that is administered by tube before or after enteral feeding of the enteral nutrient and exerts a thickening effect by calcium ions in the enteral nutrient, and when the enteral nutrient is administered by tube. An enteral nutrient set comprising a calcium ion supplier mixed with an enteral nutrient is provided.

  According to the present invention, when an enteral nutrient having a calcium ion concentration of less than 10 ppm is administered to a tube feeding recipient, the calcium ion supply agent is mixed with the enteral nutrient. Therefore, the enteral nutrient mixed with the calcium ion supply agent is mixed with the aqueous solution of low methoxyl pectin administered through the tube in the digestive tract such as the stomach to increase the viscosity. Therefore, it becomes possible to reduce or prevent vomiting. Moreover, the enteral nutrient can be thickened to such an extent that vomiting caused by tube administration can be reduced or prevented, and nutrition can be supplied while reducing or preventing vomiting caused by tube administration.

  Moreover, the enteral nutrient set comprising an enteral nutrient having a calcium ion concentration of less than 10 ppm, a low methoxyl pectin aqueous solution, and a calcium ion supply agent is the method for reducing or preventing vomiting according to the present invention, enteral nutrient. It can be applied to thickening and nutritional supplementation methods, and therefore can reduce or prevent vomiting due to tube administration, and can increase the viscosity of enteral nutrients to the extent that vomiting due to tube administration can be reduced or prevented. , And enables nutritional supplementation while reducing or preventing vomiting caused by tube administration.

  Hereinafter, the present invention will be described in detail.

  First, a method for reducing or preventing vomiting according to the present invention will be described. This method is a method for reducing or preventing vomiting caused by tube administration when an enteral nutrient having a calcium ion concentration of less than 10 ppm is administered to a tube feeding recipient. When a mixture obtained by mixing an ion supply agent is administered by tube, before or after tube administration of the mixture, a low methoxyl pectin aqueous solution that exhibits a thickening effect by calcium ions in the enteral nutrient is passed through. It is characterized by administration by tube.

  Enteral nutrients that are the subject of the present invention are those who are applied for tube feeding (that is, those who can take nutrients from the gastrointestinal tract but cannot take drinks or foods orally, either from the nose or in the abdomen. The present invention is applied to those who enter enteral nutrients into the digestive tract using a tube passed through the formed fistula into the digestive organ (specifically, in the stomach or duodenum). Here, enteral nutrients are classified into “pharmaceuticals” and “foods” according to differences in the laws they regulate. Moreover, it is classified into “component nutrient”, “digested nutrient”, “semi-digested nutrient”, and “natural concentrated liquid food” according to the difference in compositional components. Among these, those classified as “component nutrients” and “digestive nutrients” correspond to pharmaceuticals, and those classified as “natural concentrated liquid foods” correspond to foods. Those classified as “semi-digested nutrients” are classified as drugs and those classified as foods. Moreover, there are a powdery type and a liquid type depending on the formulation type. The powder form is usually used by dissolving or dispersing in lukewarm water prior to tube administration. The liquid product is used as it is or diluted with water.

  "Ingredient nutrient" is an amino acid diet composed of all chemical components such as carbohydrates, amino acids, lipids, electrolytes, vitamins, trace elements, etc. It is almost completely absorbed and almost no residue is produced. Specifically, Elental (Ajinomoto Co., Inc.), Elental P (Ajinomoto Co., Inc.), Hepan ED (Ajinomoto Co., Inc.) and the like are commercially available as pharmaceuticals.

  “Digestive nutrients” are composed of proteolysates, amino acids, etc., and require digestion to some extent compared to component nutrients, but hardly produce any residue. Specifically, twin lines (EN Otsuka Pharmaceutical Co., Ltd.), Enterudo (Terumo Co., Ltd.) and the like are commercially available.

  “Semi-digested nutrients” are those that process natural foods, contain proteins, vitamins, trace elements, etc., are superior to component nutrients in terms of taste, and have fewer residues. Specifically, as a pharmaceutical, Harmonic-F (Ajinomoto Co., Inc.), Harmonic-M (Ajinomoto Co., Inc.), Enshu Liquid (Abbott Japan Co., Ltd.), Enshua-H (Abbott Japan Co., Ltd.), Racoal (EN Otsuka Pharmaceutical Co., Ltd.), Clinimir (Morinaga Milk Industry Co., Ltd.), Amino Levan-EN (EN Otsuka Pharmaceutical Co., Ltd.), etc. are commercially available, such as Enrich SF (Meiji Dairy Co., Ltd.), etc. Is commercially available.

  “Natural concentrated liquid food” is a blend of natural foods, reduced in water and concentrated to about 1 kcal per milliliter, containing the necessary nutrients, high nutritional value, and normal digestive function It is intended for use by the most important patients. There are many residues compared to other agents. Specifically, Okunos fluid food (Horika Foods Co., Ltd.) and the like are commercially available as food.

  The specific nutritional component content, calorie amount per unit volume, serving size, etc. of the enteral nutrient described above are based on the standard numerical range as a medicine or food on the assumption that the enteral nutrient is used. You can choose. Here, in these standards, there is a reference to the total calcium content, but there is no reference to the calcium ion concentration. The present invention specifies an enteral nutrient to be applied from an unprecedented cut of calcium ion concentration. That is, in this invention, the enteral nutrient whose calcium ion concentration is less than 10 ppm becomes object. This is because an enteral nutrient having a calcium ion concentration of 10 ppm or more can reduce or prevent vomiting by using a low methoxyl pectin aqueous solution without mixing a calcium ion supplier.

  In the present invention, the calcium ion concentration is a value measured using a calcium composite electrode. Specifically, a portable pH / ion meter (Orion (registered trademark) 1219000 5-Star multimeter equipped with a calcium composite electrode (Orion 9720BNWP Sure-Flow (registered trademark), Thermo Fisher Scientific Co., Ltd.), It is the value measured at a temperature of 23 ° C. using Thermo Fisher Scientific Co.).

  Moreover, as a calcium ion supply agent, the liquid food containing a water-soluble calcium compound or the aqueous solution containing the water-soluble calcium compound applicable to a food additive or a pharmaceutical can be mentioned preferably.

  Milk refers to “milk” as defined by the Ministry of Health, Labor and Welfare's “Ministerial Ordinance on Component Standards for Milk and Dairy Products” (hereinafter referred to as the “Ministerial Ordinance on Milk”). For example, raw milk, milk, special milk, and component-adjusted milk , Low fat milk, non-fat milk, processed milk and the like. In addition, “unadjusted milk” refers to milk and special milk as defined in the “Fair Competition Rules for Labeling of Drinked Milk” (hereinafter referred to as “Fair Competition Rules”) established by the “National Drinking Milk Fair Trade Council”. Raw milk.

  The milk beverage means “a milk beverage prescribed in Article 2, Paragraph 40 of the Ministerial Ordinance of Milk and the like containing a component having a milk solid content of 3.0% or more by weight percentage” referred to in the Fair Competition Code. Among these, a milk beverage having a non-fat milk solid content of 8.0% or more is preferable. The non-fat milk solid content may be determined in accordance with the method for determining the non-fat milk solid content of milk and dairy products described in Article 7, Paragraph 1 of the Ministerial Ordinance on Milk.

  Examples of the liquid food containing the water-soluble calcium compound include milk and milk beverages, skim milk reduced solution, milk protein concentrate reduced solution and the like. On the other hand, examples of water-soluble calcium compounds corresponding to food additives and pharmaceuticals include calcium lactate, calcium chloride, and calcium gluconate.

  Among the calcium ion supply agents described above, milk and milk beverages exhibiting a preferable calcium ion concentration (70 to 150 ppm) to be described later can be particularly preferably used from the viewpoint that they are always provided in general households. Among them, as a preferable calcium ion supplier, mention may be made of unadjusted milk and non-fat milk solid content of 8.0% or more, which can show a remarkable thickening effect when used as a calcium ion supplier. Can do.

  The amount of the calcium ion supply agent (solution) added to the enteral nutrient is preferably an amount that is easy to handle and does not excessively dilute the enteral nutrient. It is preferably 5 to 100 ml per serving of nutrient.

  Moreover, as the calcium ion concentration in the calcium ion supply agent based on the amount of 5 to 100 ml per serving, if the concentration is too low, it is insufficient to reduce or prevent vomiting, and the concentration is high. If it is too much, the enteral nutrient tends to be difficult to thicken uniformly. Therefore, a preferable calcium ion concentration is 50 to 300 ppm, more preferably 70 to 200 ppm. When the calcium ion supply agent having such a calcium ion concentration is mixed with an enteral nutrient having a calcium ion concentration of less than 10 ppm (200 to 400 ml), the calcium ion concentration in the enteral nutrient after mixing is 10 ppm or more, preferably 15 to 100 ppm, more preferably 15 to 50 ppm.

  Although it is conceivable to mix a calcium ion supply agent with the enteral nutrient from the beginning, there is a risk that aggregates may be generated in the enteral nutrient when the calcium ion concentration is increased and stored for a long time. It is desirable to avoid it because it increases.

  Moreover, the aqueous solution of low methoxyl pectin is obtained by dissolving pectin having a degree of esterification of 50% or less in fresh water, and the amount added to the enteral nutrient is easy to handle and excessive enteral nutrient is used. Preferably, the amount is preferably 10 to 200 ml, more preferably 30 to 150 ml per 200 ml of enteral nutrient.

  Moreover, as a pectin concentration in a low methoxyl pectin aqueous solution premised on an amount of 10 to 200 ml per serving, if the concentration is too low, it becomes insufficient to reduce or prevent vomiting, and the concentration is too high. And enteral nutrients tend to be difficult to thicken uniformly, so 0.5 to 10% by mass, more preferably 1 to 5% by mass.

  In addition, as low methoxyl pectin to be dissolved in fresh water, those obtained from the food itself, food additives or those corresponding to pharmaceuticals can be used, such as citrus pectin such as lemon, lime, orange, grapefruit, apple pectin, etc. Can be given. In addition, the pH value of low methoxyl pectin water solubility is preferably adjusted to 3 to 6, more preferably 3.5 to 5 in order to preserve the pectin solution.

  In the method of reducing or preventing emesis caused by tube administration according to the present invention, first, a calcium ion supply agent is uniformly mixed with the enteral nutrient having a calcium ion concentration of less than 10 ppm. As a method of mixing uniformly, a calcium ion supply agent is added to the enteral nutrient at a time and mixed, or a branch tube is provided in the middle of the tube for enteral nutritional tube administration, and a little from there. It may be administered one by one. For example, when milk is used as a calcium ion supply agent, preferably 5 to 100 ml, more preferably 10 to 50 ml of milk is mixed per 200 ml of enteral nutrient.

  In the case of enteral nutrients with a calcium ion concentration of 10 ppm or more, even if a calcium ion supply agent such as milk is mixed and added, the effect of reducing or suppressing vomiting, which is a mixing effect of a low methoxyl pectin aqueous solution described later, is impaired. Absent.

  In the method for reducing or preventing emesis caused by tube administration according to the present invention, before or after, preferably before, the tube mixture is mixed with the calcium ion supply agent in the enteral nutrient, A low methoxyl pectin aqueous solution that exerts a thickening effect by calcium ions is administered by tube. Thereby, the enteral nutrient can be thickened in the digester and vomiting can be reduced or prevented.

  The above-described method for reducing or preventing vomiting caused by tube administration according to the present invention includes, as another aspect, “reducing or reducing vomiting caused by tube administration by administering a tube-fed enteral nutrient having a calcium ion concentration of less than 10 ppm or "Method of thickening to the extent that it can be prevented", and "Vomiting caused by tube administration when feeding enteral nutrition to a tube feeding applicator with a calcium ion concentration of less than 10 ppm. It can be grasped as an invention of “a method of supplying nutrition while reducing or preventing”. The significance of each specific configuration is basically the same as in the case of the “method for reducing or preventing emesis caused by tube administration” already described.

  In the case of the former method for thickening enteral nutrient, the degree of thickening is such that vomiting caused by tube administration can be reduced or prevented. Specifically, 200 ml of enteral nutrient is contained in a beaker. A mixture of 30 ml of a calcium ion supply agent and 90 ml of a low methoxyl pectin aqueous solution mixed with a spatula 100 times was mixed with a BH viscometer (23 ° C .; rotor No. 2, 20 rpm) after 5 rotations. The viscosity is preferably 300 to 5000 mPa · s, more preferably 400 to 3000 mPa · s when the degree is measured. Here, the upper viscosity value has a meaning of viscosity that does not inhibit digestion of enteral nutrients. When the viscosity is less than 200 mPa · s, the rotor No. No. 1 and when the viscosity exceeds 2000 mPa · s, the rotor no. 3 was measured in the same manner.

  In addition, the viscosity in the stomach of the low pH (about 1.2) of the mixture obtained by mixing a mixture of enteral nutrient and calcium ion supplier with an aqueous solution of low methoxyl pectin is as follows. There is a tendency to increase by about 20% from the viscosity. Therefore, in the present invention, the burden of considering that “the viscosity of the mixture decreases in the stomach environment and vomiting cannot be reduced or prevented” is reduced.

  In the case of the latter method of nutritional supplementation while reducing or preventing vomiting caused by tube administration, the significance of the present invention is nutritional supplementation because of the nutritional components of the enteral nutrient itself. Therefore, as long as the enteral nutrient contains a nutritional component, the invention of the method for supplying nutrition has significance.

  Next, the invention of “enteral nutrient set capable of reducing or preventing vomiting caused by tube administration of enteral nutrient” will be described.

  This enteral nutrient set includes (a) an enteral nutrient having a calcium ion concentration of less than 10 ppm, and (b) a tube administered before or after the tube administration of the enteral nutrient, and calcium in the enteral nutrient A low methoxyl pectin aqueous solution that exhibits a thickening effect by ions, and (c) a calcium ion supply agent that is mixed with the enteral nutrient at the time of tube administration of the enteral nutrient.

  The composition contents of (a) enteral nutrient, (b) low methoxyl pectin aqueous solution, and (c) calcium ion supply agent constituting this enteral nutrient set reduce or prevent vomiting due to the tube administration of the present invention. As described in the method of Moreover, those packaging can employ | adopt well-known packaging forms, such as canned, bottled, and a retort pouch.

  In addition, the method of use includes the “method for reducing or preventing vomiting caused by tube administration” according to the present invention, “when enteral nutritional agent having a calcium ion concentration of less than 10 ppm is administered to a tube feeding recipient. , A method of increasing the viscosity of the enteral nutrient to such an extent that vomiting caused by tube administration can be reduced or prevented, and “enteral nutrient is administered to a tube feeding applicator with a calcium ion concentration of less than 10 ppm. Thus, when nutrition is replenished, it can be used according to the “method of replenishing nutrition while reducing or preventing vomiting caused by tube administration”.

  Hereinafter, the present invention will be specifically described by way of examples.

Reference Example 1 (Preparation of enteral nutrient)
The raw materials in Table 1 were mixed with a mixer, and the mixture was homogenized with a high-pressure homogenizer at a pressure of 40 MPa. 400 ml of the obtained homogenized product is filled into a blow-formed soft bag equipped with a discharge port and capable of being sterilized by retort. Then it was cooled. A cap was attached to the plug of the obtained retort sterilized product. As a result, a soft bag-filled enteral nutrient for constructing an enteral nutrient set capable of reducing or preventing vomiting due to the tube administration of the enteral nutrient was obtained.

  The amount of calories per bag of the obtained enteric nutrient packed in a soft bag is 400 kcal. The total calcium concentration is 600 mg / 1000 ml, and a portable pH / ion meter (Orion (registered trademark)) equipped with a calcium composite electrode (Orion 9720BNWP Sure-Flow (registered trademark), Thermo Fisher Scientific Co., Ltd.). 1219000 5-Star multimeter, Thermo Fisher Scientific Co., Ltd.), the calcium ion concentration measured at a temperature of 23 ° C. was 8 ppm.

Reference Example 2 (Preparation of aqueous solution of low methoxyl pectin)
90 ml of a 3 w / v% low methoxyl pectin aqueous solution was filled in an aluminum pouch and sterilized by heating at 110 ° C. for 30 minutes. Thereby, a low methoxyl pectin aqueous solution for constituting an enteral nutrient set capable of reducing or preventing emesis caused by tube administration of the enteral nutrient was obtained.

Reference Example 3 (Preparation of calcium ion supplier)
30 ml of commercially available packed milk (calcium ion concentration = 110 ppm) was used as a calcium ion supply agent for constituting an enteral nutrient set capable of reducing or preventing vomiting caused by tube administration of enteral nutrient.

Example 1 (Enteral nutrient set)
The enteral nutrient of Reference Example 1, the aqueous low methoxyl pectin solution of Reference Example 2, and the calcium ion supply agent of Reference Example 3 of Example 1 “Enteral Enteric Can Reduce or Prevent Vomiting Due to Enteral Feeding of Enteral Nutrient. Constructed a “nutrient set”.

<Confirmation of thickening effect>
Comparative example 1 (calcium ion supply agent unused)
In a 1 liter beaker, 90 ml of a low methoxyl pectin aqueous solution of Reference Example 2 was mixed with 200 ml of the enteral nutrient of Reference Example 1, and the mixture was stirred 100 times with a spatula. When the obtained mixture was measured with a BH viscometer (23 ° C .; rotor No. 1, 20 rpm) after 5 revolutions, it showed a viscosity of 120 mPa · s. In addition, the viscosity of the enteral nutrient itself was 10 mPa · s.

Example 2 (Use of calcium ion supply agent)
In a 1 liter beaker, 200 ml of enteral nutrient (Reference Example 1) constituting the enteral nutrient set of Example 1 and 30 ml of milk as a calcium ion supply agent (Reference Example 3) were mixed. The calcium ion concentration of was 17 ppm. Furthermore, 90 ml of a low methoxyl pectin aqueous solution (Reference Example 2) constituting the enteral nutrient set of Example 1 was mixed and stirred 100 times with a spatula. The obtained mixture was measured with a BH viscometer (23 ° C .; rotor No. 2, 20 rpm) after 5 revolutions, and showed a viscosity of 1050 mPa · s. Compared with the case of 1, the viscosity increased greatly.

<Confirmation of thickening effect in the presence of artificial gastric juice>
Comparative example 2 (calcium ion supply agent unused)
In a 1 liter beaker, add 50 ml of artificial gastric juice (7.0 ml of hydrochloric acid to 2.0 ml of sodium chloride to make 1000 ml (pH = 1.2)) to 200 ml of the enteral nutrient of Reference Example 1. 90 ml of the low methoxyl pectin aqueous solution of Example 2 was mixed and stirred with a spatula 100 times. When the obtained mixture was measured with a BH viscometer (23 ° C .; rotor No. 1, 20 rpm) after 5 revolutions, it showed a viscosity of 140 mPa · s.

Example 3 (Use of calcium ion supply agent)
In a 1 liter beaker, 200 ml of enteral nutrient (Reference Example 1) constituting the enteral nutrient set of Example 1 and 30 ml of milk (Reference Example 3) as a calcium ion supply agent were mixed, and artificial gastric juice was further added. 50 ml and 90 ml of a low methoxyl pectin aqueous solution (Reference Example 2) constituting the enteral nutrient set of Example 1 were mixed and stirred 100 times with a spatula. When the obtained mixture was measured for reading after 5 rotations using a BH viscometer (23 ° C .; rotor No. 2, 20 rpm), it showed a viscosity of 1300 mPa · s. Compared to Example 2 in the absence of artificial gastric fluid, the viscosity increased by about 20%.

Examples 4-6
These examples are examples for confirming the influence on the thickening effect by the type of calcium ion supply agent. Specifically, in the enteral nutrient set of Example 1, instead of the milk of Reference Example 3 used as a calcium ion supply agent, various calcium aqueous solutions described in Table 2 having a calcium ion concentration equivalent to that of milk were used. An enteral nutrient set was constructed in the same manner as in Example 1 except that it was used, and the thickening effect in the presence of artificial gastric juice was evaluated in the same manner as in Example 3. The obtained results are shown in Table 2 together with the results of Example 3 and Comparative Example 2.

  As can be seen from the results in Table 2, in the case of Examples 4 to 6 using calcium gluconate aqueous solution, calcium lactate aqueous solution chloride or calcium chloride aqueous solution other than milk as the calcium ion supply agent, comparative examples using no calcium ion supply agent The viscosity increased by about 2.4 to 2.6 times the viscosity of 2. In the case of Example 3 where milk was used as the calcium ion supply agent, the viscosity increased by about 9 times the viscosity of Comparative Example 2 in which no calcium ion supply agent was used. Therefore, it can be seen that the thickening effect of milk as a calcium ion supply agent is conspicuous even when compared with calcium gluconate aqueous solution, calcium lactate aqueous solution or calcium chloride aqueous solution having the same calcium ion concentration.

Examples 7-11
These examples are examples for confirming the influence on the thickening effect by the type of calcium ion supply agent. Specifically, in the enteral nutrient set of Example 1, in place of the milk of Reference Example 3 used as a calcium ion supply agent, various milks or milks described in Table 3 having a calcium ion concentration comparable to that of milk. An enteral nutrient set was constructed in the same manner as in Example 1 except that the beverage was used, and the thickening effect in the presence of artificial gastric juice was evaluated in the same manner as in Example 3. The obtained results are shown in Table 3 together with the results of Example 3 and Comparative Example 2.

  As can be seen from the results in Table 3, in Examples 7 to 11 using milk or milk drinks other than milk as the calcium ion supply agent, the viscosity is about the viscosity of Comparative Example 2 in which no calcium ion supply agent is used. It increased 2.6 to 13 times. In addition, in Example 10 using a milk beverage having a non-fat milk solid content of 8.0% or more as a calcium ion supply agent, the viscosity is about 13 times that of Comparative Example 2 in which no calcium ion supply agent is used. It was increasing. Therefore, it can be seen that the thickening effect of milk with a non-component milk and non-fat milk solid content of 8.0% or more is conspicuous even when compared with milk or milk beverage having the same calcium ion concentration.

Example 12
(Confirmed anti-vomiting effect)
To 10 elderly people who are likely to vomit for tube feeding, 90 ml of a low methoxyl pectin aqueous solution (Reference Example 2) constituting the enteral nutrient set of Example 1 was tube-administered into the stomach over 30 seconds. Next, the enteral nutrient set (Example 1) (400 ml) packed in the soft bag constituting the enteral nutrient set of Example 1 is opened, and 30 ml of milk (Reference Example 3) as a calcium ion supplier is added to 200 ml thereof. They were added and mixed, and the resulting mixture was administered by tube to these 10 persons over 30 minutes. As a result, none of the 10 elderly people vomited.

Comparative Example 3
For 10 elderly people who are likely to vomit for tube feeding, 90 ml of the aqueous solution of low methoxyl pectin of Reference Example 2 was tube-administered into the stomach over 30 seconds. Next, without adding milk as a calcium ion supplier, 200 ml of the enteral nutrition supplemented with the soft bag of Reference Example 1 was administered to those 10 persons over 30 minutes. As a result, 6 out of 10 elderly people had vomiting.

<Application example of commercially available enteral nutrient of the present invention>
Comparative Example 1 (calcium ion supply agent not used) or Example 2 (calcium ion supply agent used), except that commercially available products A to C shown in Table 4 were used instead of the enteral nutrient of Reference Example 1. Similarly, the thickening effect was confirmed. The obtained results are shown in Table 4 together with the results of Comparative Example 1 and Example 2. In addition, as in Example 12 and Comparative Example 3, it was evaluated whether 10 elderly people had vomiting.

  As can be seen from Table 4, by applying the present invention to commercially available enteral nutrients having a calcium ion concentration of less than 10 ppm, it was possible to suppress or prevent vomiting due to tube administration of enteral nutrients.

  Moreover, it turns out that addition of a calcium ion supply agent does not have a bad influence about the commercially available enteral nutrient which a calcium ion concentration exceeds 10 ppm.

  The present invention provides an enteral nutritional agent having a calcium ion concentration of less than 10 ppm to a tube feeding recipient who causes vomiting due to tube administration even when a low methoxyl pectin aqueous solution for preventing vomiting is used. It is useful when administered via tube while reducing or preventing vomiting caused by tube administration.

Claims (3)

An enteral nutrient set capable of reducing or preventing vomiting due to tube administration to an enteral nutrition recipient of an enteral nutrient having a calcium ion concentration of less than 10 ppm,
Enteral nutrients with a calcium ion concentration of less than 10 ppm,
A low methoxyl pectin aqueous solution that is administered by tube before or after enteral feeding of the enteral nutrient and exerts a thickening effect by calcium ions in the enteral nutrient, and when the enteral nutrient is administered by tube. Enteral nutrient set comprising milk and / or milk beverage as a calcium ion supplier mixed with enteral nutrient. A method for strengthening calcium ions of the enteral nutrient for use with an aqueous solution of rhomethoxypectin so as to reduce or prevent vomiting due to tube administration of the enteral nutrient,
Enteral nutrients having a calcium ion concentration of less than 10 ppm are mixed with milk or dairy products before the tube administration to adjust the calcium ion concentration of the mixed enteral nutrient to 15 to 50 ppm. A method for strengthening calcium ions in nutritional agents. An enteral nutrient set capable of reducing or preventing vomiting due to tube administration to an enteral nutrition recipient of an enteral nutrient having a calcium ion concentration of less than 10 ppm,
An enteral nutrient having a calcium ion concentration of less than 10 ppm, and a low methoxyl pectin aqueous solution that is administered by tube before or after the enteral nutrient is administered and exhibits a thickening effect by calcium ions in the enteral nutrient;
Including
An enteral nutrient set in which milk and / or a milk drink are mixed as a calcium ion supply agent with an enteral nutrient when the enteral nutrient is administered by tube.