Constipation is more frequent than diarrhea in patients fed exclusively by enteral nutrition: results of an observational study.
BACKGROUND
Digestive complications in enteral nutrition (EN) can negatively affect the nutrition clinical outcome of hospitalized patients. Diarrhea and constipation are intestinal motility disorders associated with pharmacotherapy, hydration, nutrition status, and age. The aim of this study was to analyze the frequency of these intestinal motility disorders in patients receiving EN and assess risk factors associated with diarrhea and constipation in hospitalized patients receiving exclusive EN therapy in a general hospital.


METHODS
The authors performed a sequential and observational study of 110 hospitalized adult patients fed exclusively by EN through a feeding tube. Patients were categorized according to the type of intestinal transit disorder as follows: group D (diarrhea, 3 or more watery evacuations in 24 hours), group C (constipation, less than 1 evacuation during 3 days), and group N (absence of diarrhea or constipation). All prescription drugs were recorded, and patients were analyzed according to the type and amount of medication received. The authors also investigated the presence of fiber in the enteral formula.


RESULTS
Patients classified in group C represented 70% of the study population; group D comprised 13%, and group N represented 17%. There was an association between group C and orotracheal intubation as the indication for EN (P < .001). Enteral formula without fiber was associated with constipation (logistic regression analysis: P < .001).


CONCLUSIONS
Constipation is more frequent than diarrhea in patients fed exclusively by EN. Enteral diet with fiber may protect against medication-associated intestinal motility disorders. The addition of prokinetic drugs seems to be useful in preventing constipation.
GANEP–Nutricao Humana, Sao Paulo, Brazil. a.bittencourt@hotmail.com.br
Amanda F
AF
Bittencourt
Juliana R
JR
Martins
Luciana
L
Logullo
Glaucia
G
Shiroma
Lilian
L
Horie
Maria Claudia
MC
Ortolani
Maria de Lourdes T
Mde L
Silva
Dan L
DL
Waitzberg
D000368:Aged; D001938:Brazil; D003248:Constipation / Q000209:etiology / Q000503:physiopathology*; D003967:Diarrhea / Q000209:etiology / Q000503:physiopathology*; D004043:Dietary Fiber / Q000008:administration & dosage; D004750:Enteral Nutrition / Q000009:adverse effects*; D005260:Female; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D009752:Nutritional Status; D012189:Retrospective Studies; D012307:Risk Factors