Diarrhea in enterally fed patients: blame the diet?

被引:48
作者
Chang, Sue-Joan [1 ]
Huang, Hsiu-Hua [1 ,2 ]
机构
[1] Natl Cheng Kung Univ, Dept Life Sci, Coll Biosci & Biotechnol, Tainan 701, Taiwan
[2] Taipei Vet Gen Hosp, Dept Food & Nutr, Taipei, Taiwan
关键词
causes of diarrhea; enteral feeding; nosocomial diarrhea; nutritional intervention; CRITICALLY-ILL PATIENTS; CHAIN FATTY-ACIDS; CLOSTRIDIUM-DIFFICILE INFECTION; INTENSIVE-CARE-UNIT; CONTROLLED-TRIAL; DOUBLE-BLIND; GASTROINTESTINAL SYMPTOMS; FRUCTO-OLIGOSACCHARIDES; HUMAN LACTOFERRIN; FECAL MICROBIOTA;
D O I
10.1097/MCO.0b013e328363bcaf
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Purpose of reviewDiarrhea has great impact on enteral nutrition. The purpose of this review is to identify the factors leading to diarrhea during enteral nutrition and to provide the published updates on diarrhea prevention through nutritional intervention.Recent findingsDiarrhea in enteral fed patients is attributed to multiple factors, including medications (major contributor), infections, bacterial contamination, underlying disease, and enteral feeding. Diet management can alleviate diarrhea in enteral feeding. High content of fermentable oligosaccharides, disaccharides, and monosaccharides and polyols (FODMAPs) in enteral formula is postulated to induce diarrhea and lower FODMAPs formula may reduce the likelihood of diarrhea in enterally fed patients. Fiber-enriched formula can reduce the incidence of diarrhea and produce short-chain fatty acids for colonocytes. Ingesting prebiotics, nonviable probiotics or probiotic derivatives, and human lactoferrin may provide alternatives for reducing/preventing diarrhea.SummaryEnteral feeding is not generally considered the primary cause of diarrhea, which is frequently linked to prescribed medications. When diarrhea is apparent, healthcare members should evaluate the possible risk factors and systematically attempt to eliminate the underlying causes of diarrhea before reducing or suspending enteral feeding. Lower FODMAPs formula, prebiotics, probiotic derivatives, and lactoferrin may be used to manage enteral feeding-related diarrhea.
引用
收藏
页码:588 / 594
页数:7
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