Intestinal obstruction from cecal bezoar; a complication of fiber-containing tube feedings.
Dietary fiber increases stool bulk, regulates bowel transit time, and decreases intraluminal pressure. Because these actions constitute a natural way to stop diarrhea, a frequent problem with tube feedings, enteral tube feeding manufacturers have marketed several fiber-containing formulae. While bulk-forming agents such as fiber may not be appropriate for every tube-fed patient, we were unable to find any published contraindications to the use of fiber-containing enteral products. We present the case of a seriously ill man who received a fiber-containing tube feeding while also getting intestinal motility-suppressing medications. A large fiber bezoar developed, with resultant mesenteric hemorrhage. We conclude that fiber-containing tube feedings are contraindicated in certain types of patients.
McIvor
A C
AC
Department of Surgery, SUNY Health Science Center, Syracuse 13210.
Meguid
M M
MM
Curtas
S
S
Warren
J
J
Kaplan
D S
DS
D001630:Bezoars / Q000150:complications / Q000209:etiology; D002429:Cecal Diseases / Q000150:complications / Q000209:etiology; D003967:Diarrhea / Q000628:therapy; D004043:Dietary Fiber / Q000008:administration & dosage / Q000009:adverse effects*; D004750:Enteral Nutrition / Q000009:adverse effects*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology*; D008297:Male; D008875:Middle Aged