To the Editor.–The article by Choctaw and associates (Archives 1980;115: 1073-1076) suggests that the use of an elemental diet may prevent upper gastrointestinal (GI) bleeding through "dilutional alkalination." Although this may be a major pathway, I wish to call attention to other information that describes decreased gastric acid production as a result of elemental feedings. In this study, gastric acid production was measured after use of blenderized and elemental (Vivonex) diets that were administered as bolus (300 to 600 mL) tube feedings. A decreased acid production was noted after the elemental diet, as opposed to the blenderized diet. This may also help to explain the decrease in GI bleeding that was observed in Dr Choctaw's study.
CRONEN P. Upper Gastrointestinal Bleeding in Burn Patients. Arch Surg. 1981;116(7):970. doi:10.1001/archsurg.1981.01380190094024