The patient with severe burns is characterized by a hypermetabolic response, and degree of which is proportional to the magnitude of burns. Major thermal injury is often associated with gastrointestinal dysfunction. Failure to provide adequate caloric intake by both enteral and parenteral routes will results in pronounced weight loss, delayed wound healing, depression of host resistance and cellular dysfunction. We analysed 676 burn patients with TBSA over 50%, and found regular changes in gastrointestinal function with endoscopy and also at autopsy. A new dietary programme is described in the article.