Bowel function of long-term tube-fed patients consuming formulae with and without dietary fiber.
Diarrhea, constipation and subsequent laxative use are chronic problems in long-term enterally fed patients. We have conducted a double-blind randomized crossover study to evaluate the effects of two enteral formulae (Enrich, 12.8 g of dietary fiber per 1000 kcal and Ensure, fiber-free) on stool frequency, fecal weight, laxative use, gastrointestinal tolerance and bowel function in chronic care tube-fed patients. Twenty-eight subjects (24 male, 4 female) completed the study. Mean daily number of stools and mean daily fecal wet weight in Enrich-fed patients were not significantly different from those of patients receiving Ensure. Ensure-fed patients required significantly more laxatives (p = 0.02) than those receiving Enrich. There were 26 reports of diarrhea in the Ensure-fed group as compared to 6 in the Enrich-fed group, and this difference was significant (p = 0.006). Reporting rates for constipation were not significantly different in the two groups. At the end of the study, the bowel function of 57.1% of patients receiving Enrich was improved when compared with that of 14.3% of Ensure-fed patients, and this difference was significant (p = 0.005). These results suggest that the addition of dietary fiber to enteral formulae improves gastrointestinal tolerance and bowel function, and reduces laxative use in long-term enterally fed patients.
Shankardass
K
K
Chedoke-McMaster Hospitals, Hamilton, Ontario, Canada.
Chuchmach
S
S
Chelswick
K
K
Stefanovich
C
C
Spurr
S
S
Brooks
J
J
Tsai
M
M
Saibil
F G
FG
Cohen
L B
LB
Edington
J D
JD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003672:Defecation / Q000187:drug effects*; D004043:Dietary Fiber / Q000008:administration & dosage / Q000494:pharmacology*; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D005526:Food, Formulated; D006801:Humans; D007420:Intestine, Large / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D013997:Time Factors