The provision of enteral nutritional support has developed rapidly in the past 5 years for a number of different reasons. Advances in our understanding of the processes of nutrient absorption have led to the development of formulas that are more physiologic. Of course, without safe and effective means of access to the gastrointestinal tract, even the best diet would not be adequate if intake were limited by poor techniques of administration. The physiology of the gastrointestinal tract is better understood, particularly with respect to what happens to small and large bowel motility and fluid flows during normal eating or during continuous nasoenteral infusion in both health and disease. Thus it is now feasible to provide diets that will meet all nutrient requirements, which contain substrates thought to beneficially moderate the inflammatory response, and which can be delivered by a number of routes other than through a nasoenteral tube. This review attempts to summarize a diverse literature.