[Diarrhea during enteral feeding].
BACKGROUND
Diarrhea 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 diarrhea used.


CONCLUSIONS
Diarrhea increases morbidity, particularly since the nutritional goals are harder to reach.


METHODS
Relevant causes today are related to the nutrition (irregular and too high output, jejunal site, low sodium and fiber 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).


METHODS
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.
Schneider
Stéphane M
SM
Fédération d'hépato-gastroentérologie et de nutrition clinique, Hôpital de l'Archet, Nice (06). stephane.schneider@unice.fr
Hébuterne
Xavier
X
D003967:Diarrhea / Q000453:epidemiology* / Q000628:therapy*; D004750:Enteral Nutrition / Q000009:adverse effects*; D006801:Humans; D009017:Morbidity; D009747:Nutritional Physiological Phenomena; D014882:Water-Electrolyte Balance