Diarrhea during enteral feeding
Schneider, Séphane.M.; Hébuterne, X.
Presse Medicale 32(20): 935-941
2003
ISSN/ISBN: 0755-4982 PMID: 12876540 Document Number: 555697
Diarrhoea occurs in 2 to 70% of tube-fed patients, depending on their disease (with an increased risk in critically ill patients) and on the definition of diarrhoea used. Diarrhoea increases morbidity, particularly since the nutritional goals are harder to reach. Relevant causes today are related to the nutrition (irregular and too high output, jejunal site, low sodium and fibre contents), to the patient (malnutrition, stress, underlying diseases), and predominantly to concomitant treatments (antibiotics, with an increased risk of Clostridium difficile infection, laxative-containing drugs). Treatment of the cause is only valid when it has been identified. Symptomatic treatment principally combines compensation for water and electrolyte loss and drugs that slow down the transit. Prevention associates the regulation of the administration rate and the fight against Clostridium difficile. Restoration of the colonic microflora appears the key to success and some prebiotics and probiotics have demonstrated preventive effects. Further research in this direction is warranted.