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Strategies to Manage Gastrointestinal Symptoms Complicating Enteral FeedingFrom Monash University, Department of Medicine, and Department of Gastroenterology, Box Hill Hospital, Box Hill Victoria Australia. Address correspondence to: Jacqueline Barrett, M Nutr Diet, Department of Gastroenterology, Box Hill Hospital, Box Hill, Victoria 3128, Australia; e-mail: jacqueline.barrett{at}med.monash.edu.au.
Diarrhea and abdominal distension are common complications associated with enteral feeding. Often the cause is unknown, the enteral formula is blamed and changes to the mode of delivery or formula are instituted. However, the evidence base for many strategies used is limited. Altering the osmolality and temperature of the formula and/or the rate of infusion are commonly practiced but evidence for their benefit is largely anecdotal. Preventing microbial contamination of the feed is important and clear guidelines exist to achieve this. The formulation itself can be modified. While the addition of fiber is well supported theoretically, outcome data are less convincing. Avoidance of osmotically active, poorly absorbed short-chain carbohydrates in the formula (often used as the major carbohydrate source) is a new tactic to minimize diarrhea. It has compelling theoretical support, but requires further investigation. A methodical clinical approach to gastrointestinal complications of enteral feeding is warranted and an algorithm for management is proposed.
Key Words: enteral nutrition • FODMAPs • diarrhea • enteral formula
This version was published on January
1, 2009 Journal of Parenteral and Enteral Nutrition, Vol. 33, No. 1,
21-26 (2009) This article has been cited by other articles:
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