Diarrhea in enterally fed patients

Chang, Shang‐Jen; Huang, Hsiu Hua

doi:10.1097/mco.0b013e328363bcaf

Cited by 55 publications

(59 citation statements)

References 39 publications

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“…Rationale: Diarrhea in ICU patients receiving EN is common but may be serious, as the incidence ranges from 2%–95% and often results in electrolyte imbalance, dehydration, perianal skin breakdown, and wound contamination 152 . If unable to control the diarrhea, clinicians often stop EN, with resulting inadequate nutrition intake.…”

Section: Monitoring Tolerance and Adequacy Of Enmentioning

confidence: 99%

“…The following factors may contribute to acute diarrhea: type and amount of fiber in formula, osmolality of formula, delivery mode, EN contamination, medications (antibiotics, proton‐pump inhibitors, prokinetics, glucose lowering agents, nonsteroidal antiinflammatory drugs, selective serotonin reuptake inhibitors, laxatives, and sorbitol‐containing preparations, in particular), and infectious etiologies, including Clostridium difficile 152 . Studies have shown an association between short‐chain carbohydrates fermentable oligosaccharides, disaccharides and monosaccharides, and polyols (FODMAPS) and diarrhea, as they are highly osmotic and rapidly fermented by gut bacteria.…”

Section: Monitoring Tolerance and Adequacy Of Enmentioning

confidence: 99%

See 1 more Smart Citation

Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient

McClave

Taylor

Martindale

et al. 2016

J Parenter Enteral Nutr

2,650

1,248

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Section: Monitoring Tolerance and Adequacy Of Enmentioning

confidence: 99%

Section: Monitoring Tolerance and Adequacy Of Enmentioning

confidence: 99%

Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient

McClave

Taylor

Martindale

et al. 2016

J Parenter Enteral Nutr

2,650

1,248

View full text Add to dashboard Cite

“…Clostridium difficile and associated diarrhea in hospitalized tube‐fed patients have been correlated with EN, especially in those receiving postpyloric feeding 68 , 69 . With the steady increase in this very serious malady, every potential correlation must be considered, including medications, underlying disease, and prior status, but bacterial contamination must also be considered 70 . There are many potential causes of frequent and/or loose stools, including medications, underlying disease, and prior status, but bacterial contamination must be considered 70 .…”

Section: Section 6 Administration: Generalmentioning

confidence: 99%

ASPEN Safe Practices for Enteral Nutrition Therapy

Boullata

Carrera²,

Harvey

et al. 2016

J Parenter Enteral Nutr

352

531

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Enteral nutrition (EN) is a valuable clinical intervention for patients of all ages in a variety of care settings. Along with its many outcome benefits come the potential for adverse effects. These safety issues are the result of clinical complications and of process-related errors. The latter can occur at any step from patient assessment, prescribing, and order review, to product selection, labeling, and administration. To maximize the benefits of EN while minimizing adverse events requires that a systematic approach of care be in place. This includes open communication, standardization, and incorporation of best practices into the EN process. This document provides recommendations based on the available evidence and expert consensus for safe practices, across each step of the process, for all those involved in caring for patients receiving EN.

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“…However, the diarrhea suffered by patients on EN is often due to medication use, infections, problems caused by their underlying disease, or the feeding method, rather than by the enteral formula as such (20,21). The use of fiber-enriched formulas helps to regulate bowel function, reducing the incidence of diarrhea (14,22) and constipation (increasing bowel movements, if baseline frequency is low, and reducing them, if baseline frequency is high) (22).…”

Section: Discussionmentioning

confidence: 99%

The effects on nutritional status, bowel habits and tolerance of a high- protein, high-calorie, fiber- and fructo-oligosaccharide-enriched enteral formula: Safety and Effectiveness of Enteral Nutrition in Spanish patients (SENS Study).

et al. 2017

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on behalf of the SENS Working Group. The effects of a high-protein, high-calorie, fiber-and fructooligosaccharide-enriched enteral formula on nutritional status, bowel habits and tolerance: Safety and Effectiveness of Enteral Nutrition in elderly Spanish patients (SENS Study ResumenIntroducción: la nutrición enteral es una intervención efectiva para pacientes desnutridos o en riesgo de sufrir desnutrición. Sin embargo, puede desencadenar complicaciones como intolerancia gastrointestinal, hiperglicemia o síndrome de realimentación. Objetivo: investigar los efectos de una fórmula de nutrición enteral por sonda en el estado nutricional y bioquímico, hábitos gastrointestinales y seguridad de los pacientes. Metodología: estudio observacional, prospectivo y multicéntrico. Se incluyeron pacientes ≥ 18 años, desnutridos o en riesgo de desnutrición, tributarios de recibir una fórmula de nutrición enteral hipercalórica, hiperproteica, y rica en fibra y fructooligosacáridos. Los pacientes fueron evaluados durante 8 semanas en 3 visitas (V1, inicial; V2, 4 semanas; V3, 8 semanas). Resultados: entre V1 y V2 se observó un incremento estadísticamente significativo en peso (1,5 kg), índice de masa corporal (0,6 kg/m 2 ) e ingesta calórica (59,7 kcal/día). Entre V1 y V3, existió un descenso en el porcentaje de pacientes con valores anormales de glucosa, potasio, proteína total y albúmina. Los hábitos intestinales se mantuvieron estables durante el estudio (1,1 deposiciones diarias de media). Conclusión: la fórmula fue segura, tolerada, y mejoró el estado nutricional del paciente sin alterar los hábitos intestinales. AbstractBackground: Enteral nutrition (EN) is an effective nutritional intervention for patients at risk of malnutrition or malnourished. However, complications such as gastrointestinal intolerance, hyperglycemia or refeeding syndrome can be triggered by EN. Aim: To investigate the effects of a tube feeding formula (TFF) on patients' nutritional status, biochemical status, bowel habits and safety. Methodology: Observational, prospective and multicenter study. Patients ≥ 18 years, undernourished or at nutritional risk, who were prescribed a high-calorie, high-protein, fiber-fortified TFF were included. Patients were evaluated over a period of eight weeks (baseline [V1], four weeks [V2] and eight weeks [V3]). Results: A statistically significant increase in weight (1.5 kg), body mass index (0.6 kg/m 2 ) and nutritional intake (59.7 kcal/day) was observed between V1 and V2. Between V1 and V3, there was a statistically significant decrease in the percentage of individuals with abnormal biochemical markers for glucose, potassium, total protein and albumin. The number of patients' bowel movements remained stable throughout the study with a mean of 1.1 daily bowel movements. Conclusion: The TFF was safe and well tolerated, improving patients' nutritional status without altering patients' bowel habits.

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Diarrhea in enterally fed patients

Cited by 55 publications

References 39 publications

Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient

Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient

ASPEN Safe Practices for Enteral Nutrition Therapy

The effects on nutritional status, bowel habits and tolerance of a high- protein, high-calorie, fiber- and fructo-oligosaccharide-enriched enteral formula: Safety and Effectiveness of Enteral Nutrition in Spanish patients (SENS Study).

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