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Diarrhea associated with nasogastric feedings
J L Reese1, M E Means, K Hanrahan
1College of Nursing, University of Iowa, Iowa City, USA.
Oncology Nursing Forum
|January 1, 1996
Summary
Fiber formulas reduced diarrhea in males but not females receiving nasogastric (NG) tube feedings. Antibiotics and food aversions increased diarrhea risk. Interval feedings decreased GI discomforts.
Area of Science:
- Gastroenterology
- Clinical Nutrition
- Oncology Nursing
Background:
- Nasogastric (NG) tube feeding is common in head and neck cancer patients.
- Diarrhea and gastrointestinal (GI) discomforts are frequent complications of NG tube feeding.
- The role of fiber content in enteral formulas and feeding schedules on GI tolerance requires further investigation.
Purpose of the Study:
- To compare diarrhea incidence with varying fiber concentrations in NG tube formulas.
- To identify factors influencing diarrhea and GI discomforts during NG tube feeding.
- To evaluate the impact of switching from continuous to interval feeding schedules.
Main Methods:
- Prospective, double-blind, randomized study involving 80 adult patients undergoing head and neck cancer surgery.
- Administration of NG tube formulas with 0, 7, or 14 g/L fiber via continuous feeding, followed by interval feeding.
- Documentation of diarrhea, GI discomforts, and relevant patient variables (gender, food aversions, antibiotic use).
Main Results:
- Female gender, prior food aversions, and broad-spectrum antibiotic use were significant predictors of diarrhea.
- Males receiving fiber-free formula experienced diarrhea four times more frequently.
- 70% of subjects reported GI discomforts with continuous feeding versus 50% with interval feeding.
Conclusions:
- Fiber-containing formulas effectively reduced diarrhea in male patients but not in females.
- Antibiotic use significantly increased diarrhea risk, consistent with existing literature.
- While interval feeding reduced discomfort, both feeding schedules require careful monitoring.