Diarrhea and constipation in hospitalized patients treated with
fiber-exclusive enteral therapy: longitudinal study
Abstract
Background and objectives: Studies analyzing the frequency of diarrhea
and constipation with exclusive enteral nutrition therapy (ENT) enriched
with fibers assessing the time effect in clinical outcomes are scarce.
So, this was the aim of the present study. Methods: This is a
prospective study carried out in hospitalized patients who were fed
exclusively on ENT for at least seven days. Those patients were followed
daily until reaching 14 days of exclusive ENT diet. The frequency of
diarrhea and constipation, the data related to the ENT, the liquids and
the medicines received were logged daily. Generalized Estimated Equation
was used for statistical analysis (p<0.05). Results: The
sample was of 28 patients (64.21±17.70 years and 75% men), 15 patients
remained until the end of the study. The percentage of diarrhea was
3.6% to 14.3%, and constipation was 32.1% to 0% (p=0.035). Normal
intestine function was more frequent and increased during the study
(p=0.001). Patients with diarrhea and constipation presented lower
infusion speed, dietary volume and adequacy of total fibers
(p<0.05). The daily medication was the only variable that
remained associated to diarrhea (β=0.125;p=0.04) after multivariated
analyses. Age (β=-0.021;p<0.001) and liquids (β=-0.001;
p<0.001) were inversely associated to constipation. The use
medicines that reduced intestine motility was also associated with
constipation (p<0.001). The prevalence of patients without
gastrointestinal dysfunction using fiber-enriched diet was more
expressive during the study. Conclusion: Age, medication and liquids
were associated to both diarrhea and constipation.