Nutrition
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Randomized Controlled Trial Clinical Trial
Diarrhea with enteral feeding: prospective reappraisal of putative causes.
Our objective was to test, in tube-fed patients whether treatment with antibiotics, the presence of hypoalbuminemia, or the use of hypertonic tube feeding is associated with a higher incidence of diarrhea; how often tube feeding actually causes diarrhea; and whether administration of a Lactobacillus preparation reduces the incidence of diarrhea. Our study design included a randomized, double-blind, placebo-controlled trial of patients on tube feeding for at least 5 days. Stool weights and clinical assessment of bowel function were used as outcome measures. ⋯ Diarrhea occurs more commonly in tube-fed patients who have low serum albumin levels and have been treated with antibiotics for long periods, but these associations are generally not causal. Hypertonic feeding formulas are not associated with increased risk of diarrhea. Most cases of diarrhea in tube-fed patients are caused by factors extraneous to the tube feeding.