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Diarrhea is the most commonly reported gastrointestinal complication of tube feeding, reports the American Dietetic Association 1. There are many possible causes of diarrhea when you are on tube feeding, and a slew of potential solutions. Choosing the right solution for the right cause can mean the difference between resolution of diarrhea and worsening of symptoms.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
The American Society for Parenteral and Enteral Nutrition describes enteral nutrition, or tube feeding, as liquid food given through a tube into the stomach or small bowel. In 1995, Medicare and its beneficiaries spent $660 million dollars on enteral nutrition products. Diarrhea is defined as more than three large, watery stools per day, says MedlinePlus 3. You may also experience abdominal cramps, bloating and a feeling of urgency.
- The American Society for Parenteral and Enteral Nutrition describes enteral nutrition, or tube feeding, as liquid food given through a tube into the stomach or small bowel.
Why Water Causes Diarrhea
Many drugs in liquid form have a high osmolality, or number of particles, which contributes to loose stools. Formula contamination caused by improper handling and storage of formula and equipment can also induce diarrhea, cautions the Oley Foundation. Likewise, gastrointestinal infections, or over-colonization of bacteria, can irritate the intestine and lead to watery stools.
Solutions and Prevention
Ask your doctor or pharmacist if any of the prescriptions you are taking could contribute to diarrhea. Simply changing the form that your medication comes in could resolve loose stools. To prevent contamination, the Oley Foundation recommends that you use good hand washing technique, wash all equipment with warm water, and check formula expiration dates. Use one bag for no more that 48 hours, and hang formula for no more than eight to 12 hours. If diarrhea develops after a course of antibiotics, check with your doctor before taking antidiarrheal medication that could make you sicker if you have a C. difficile or E. coli infection, warns the Merck Manual.
- Ask your doctor or pharmacist if any of the prescriptions you are taking could contribute to diarrhea.
- If diarrhea develops after a course of antibiotics, check with your doctor before taking antidiarrheal medication that could make you sicker if you have a C. difficile or E. coli infection, warns the Merck Manual.
How to Treat Diarrhea in a Four Year Old
If diarrhea is severe or prolonged, dehydration or loss of electrolytes can occur. Decrease the rate of tube feeding until diarrhea improves. Stopping completely may contribute to dehydration and electrolyte loss. The Oley Foundation advises that you contact your doctor if diarrhea increases notably, or lasts for more than 24 hours. Call your doctor if there is blood in your stool, or if you experience severe abdominal pain.
- If diarrhea is severe or prolonged, dehydration or loss of electrolytes can occur.
- The Oley Foundation advises that you contact your doctor if diarrhea increases notably, or lasts for more than 24 hours.
The Oley Foundation recommends adding fiber to your daily tube feeding regimen, or switching to a fiber-containing formula, to help make your stools more formed. Consider using probiotics -- the National Center for Complementary and Alternative Medicine recognizes these helpful bacteria as effective in treating diarrhea. Standard tube feeding formulas are generally isotonic, lactose-free, low in fat and well tolerated, states A.S.P.E.N Nutrition Support Core Curriculum. Changing your formula to a specialized, peptide-based or elemental one is expensive, and usually not warranted until other methods are exhausted.
- The Oley Foundation recommends adding fiber to your daily tube feeding regimen, or switching to a fiber-containing formula, to help make your stools more formed.
Why Water Causes Diarrhea
How to Treat Diarrhea in a Four Year Old
Metamucil & Diarrhea
How to Stop Diarrhea When Pregnant
Home Remedies for Diarrhea in Infants
Rice Congee for Diarrhea
Causes of Explosive Diarrhea
Home Remedies for Diarrhea in Adults
Home Remedies for Diarrhea in 1 Year Old
Causes of Yellow Diarrhea
- American Dietetic Association: Enteral Nutrition Gastrointestinal Complications
- DHHS Office of Inspector General: Enteral Nutrition Therapy Medical Necessity
- MedlinePlus: Diarrhea
- Merck Manuals: Gastroenteritis
- U.S. Department of Health and Human Services. Symptoms & Causes of Diarrhea. Updated November 2016.
- Centers for Disease Control and Prevention. Managing Acute Gastroenteritis Among Children. Published November 10, 2003.
- U.S. Department of Health and Human Services. Treatment for Diarrhea.Updated November 2016.
- Mayo Clinic. Diarrhea. Last reviewed June 16, 2020.
- Quigley EMM. Prebiotics and probiotics in digestive health. Clin Gastroenterol Hepatol. 2019;17(2):333-344. doi:10.1016/j.cgh.2018.09.02
- Su G, Ko C, Bercik, P, ET al. AGA clinical practice guidelines on the role of probiotics in the management of gastrointestinal disorders. Gastroenterology. June 9 2020. doi:https://doi.org/10.1053/j.gastro.2020.05.059
- U.S. National Library of Medicine. Clostridium Difficile Infections. Updated June 3, 2019.
- Churgay CA, Aftab Z. Gastroenteritis in children: Part II. Prevention and management. Am Fam Physician. 2012;85(11):1066-1070.
- McFarland LV, Goh S. Are probiotics and prebiotics effective in the prevention of travelers' diarrhea: A systematic review and meta-analysis.Travel Med Infect Dis. 2019;27:11-19. doi:10.1016/j.tmaid.2018.09.007
- World Bank Group. Oral rehydration solutions (ORS) [PDF]. 2019.
- “ASPEN Nutrition Support Core Curriculum”; Gottschlich, Michelle; 2007
Amy Long Carrera is a registered dietitian in Los Angeles who has been writing since 2007 for such publications as The Insider, On the Other Side and Arthritis Today. She is a certified nutrition support clinician and her writing employs current research to provide evidence-based nutrition information. Carrera holds a master of science degree in nutrition from California State University, Northridge.