Intermittent vs. continuous: a comparative narrative review of enteral and parenteral nutrition support strategies in the perioperative setting

Enteral and parenteral nutrition are two primary methods of nutritional support in clinical settings. Their administration modes—continuous or intermittent—have garnered increasing attention in recent research. Continuous enteral and parenteral nutrition provide steady metabolic support over extended periods, particularly beneficial for critically ill patients or those with high nutritional demands. Conversely, intermittent feeding, delivered at scheduled intervals, simulates natural eating patterns and may offer advantages in gastrointestinal function and metabolic regulation. Recent studies indicate notable differences between continuous and intermittent feeding in perioperative patients, especially regarding metabolic control, gastrointestinal tolerance, immune function, and postoperative complications. Continuous feeding simplifies clinical management through stable nutrient delivery but may increase the risks of metabolic overload, liver dysfunction, and gastrointestinal intolerance. In contrast, intermittent feeding promotes recovery of gastrointestinal function and potentially reduces the risk of infections and other postoperative complications. This review aims to assess the clinical outcomes of continuous versus intermittent enteral and parenteral nutrition in perioperative patients, with a primary focus on gastrointestinal surgery populations (where gut-specific mechanisms are most critical). By evaluating these feeding strategies in terms of postoperative complications, recovery, metabolic regulation, and quality of life, we seek to provide evidence-based recommendations for optimizing perioperative nutritional care and improving patient outcomes.