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.