The nutritional needs of the gastrointestinal mucosa per se has until today been largely neglected. It is a rather novel finding, that the lower part of the digestive tract is most dependent on luminal nutrition for maintaining its integrity, structure and function. Even the most complete parenteral nutrition (PN) regimen cannot, in the absence of adequate enteral nutrition (EN), fully prevent the development of mucosal atrophy in the lower part of the digestive tract, especially the colon. Nor can PN prevent the downregulation of the colon's many important functions. Increased microbial translocation and a predisposition to sepsis are consequences of inadequate luminal nutrition. Such developments can only be prevented by oral feeding and the local 'manufacturing' of essential nutrients in the colon. Probiotic bacteria are also important, especially with respect to the function of the colonic mucosa, which is the focus of this review.