Jerusalem artichoke powder mixed in enteral feeding for patients who have diarrhea in surgical intensive care unit: Method of preparation and pilot study

Objective: The Jerusalem artichoke (Helianthus tuberosus L.) is a tuber with high soluble fiber. The objective of this study was to demonstrate the method of preparation and pilot test this substance as an additive to enteral feeding. Materials and methods: We processed Jerusalem artichoke into a 600 micrometers powder, tested its properties, and pilot tested its use in patients who had diarrhea (King’s stool score ≥12) in a surgical intensive care unit. Two grams of Jerusalem artichoke powder were mixed in each 100 mL of hospital enteral feeding formula and administered for 5 days. Results: Artichoke powder slightly increased the viscosity of enteral feeding formula. The dietary fiber content of the mixture was 20.8–21.6 g% and the content of fructans was 66.0–71.5 g%. In the pilot study in 11 patients, diarrhea was improved (diarrhea score < 12) in 7/11 (63.6%) patients by day 5. Improvement in diarrhea started on day 2 [median different diarrhea score (interquartile range): −4 (−8 to 0); p =0.03] and peaked by days 4 and 5 [−7(−10 to −3); p < 0.01 and −8(−12 to −4); p < 0.01, respectively]. There were no complications during the study except three patients had a high gastric residual volume (>200 mL). Conclusion: Processed powder of Jerusalem artichoke tuber has a high fiber content and increases viscosity of enteral feeding solutions only slightly. When administered as part of enteral nutrition to critically ill surgical patients, the diarrhea score improves in most patients.