Control of diarrhea by fiber-enriched diet in ICU patients on enteral nutrition: a prospective randomized controlled trial.
OBJECTIVE
Enteral fiber-free diets alter intestinal transit and produce diarrhea or constipation. This prospective double blind, controlled study evaluates the use of guar gum, a soluble fiber and a candidate prebiotic in enteral feeds, to prevent diarrhea and potential health benefits in intensive care unit patients.


METHODS
Twenty patients on enteral nutrition with persistent diarrhea were randomized to receive a new enteral feed either enriched with 2% soluble guar gum (study group, n = 10) or fiber-free (control group, n = 10) for 4 successive days.


RESULTS
The number of liquid stools in response to a soluble fiber-enriched diet was 2.0+/-0.9 (first day) vs. 1.0+/-0.7 (fourth day) (P < 0.01), and in the control group 1.2+/-0.7 (first day) vs. 2.1+/-0.8 (fourth day) (P < 0.05). In the fiber-enriched feed group, plasma glucose and cholesterol levels at termination of the study, respectively, reached 126+/-81 and 164+/-71 mg dl(-1), as compared to 333+/-108 and 378+/-26 mg dl(-1) on Day first (P < 0.01). In the control group, these values on the fourth day were, respectively, 267+/-94 and 263+/-79 vs. 247+/-115 and 315+/-78 on Day first (P > 0.05).


CONCLUSIONS
Guar gum-enriched enteral nutrition was related to a decrease of diarrheal episodes in ICU patients with preexisting diarrhea; and to a trend for lower plasma glucose and cholesterol levels.
Rushdi
T A Tarek Ali
TA
Faculty of Medicine, New Kasr El-Aini Teaching Hospital, Cairo University, Cairo, Egypt.
Pichard
Claude
C
Khater
Y H Yehia Helmy
YH
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D002784:Cholesterol / Q000097:blood; D003967:Diarrhea / Q000517:prevention & control* / Q000628:therapy*; D004043:Dietary Fiber / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods; D005260:Female; D005685:Galactans / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008351:Mannans / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D053149:Plant Gums; D011446:Prospective Studies; D012995:Solubility
D001786:Blood Glucose; D004043:Dietary Fiber; D005685:Galactans; D008351:Mannans; D053149:Plant Gums; D002784:Cholesterol; C007894:guar gum