Journal of Clinical Nutrition & Dietetics

Formula Switch Leads to Enteral Feeding Tolerance Improvements in Adults: A Case Series

Enteral Nutrition (EN) is a life-sustaining treatment for individuals across care settings. EN Intolerance (ENI) is a common complication associated with EN. A variety of strategies are utilized to manage ENI, including the switch from polymeric to Peptide-Based Diets (PBD). Despite the necessity of EN and the prevalence of reported gastrointestinal complications, there remains a paucity of published data regarding ENI and potential benefits of PBD as a management strategy. This case series reports our experience with ENI in adults living in a complex continuing care facility. A total of 10 eternally-fed patients (4 women and 6 men) with ENI, average age of 64 years [± 10], were switched from a polymeric formula to a 100% whey PBD. Data on overall feeding tolerance was available for 8/10 patients. In all eight, feeding tolerance was reported as improved after switch. Of the ENI symptoms reported at baseline, improvements were observed in excessive gas or abdominal distention (2/4 cases); loose stool (4/6 cases); constipation (1/2 cases); elevated gastric residuals (2/2 cases); and “other” signs of intolerance (4/6 cases). Vomiting was unchanged (1/2 cases) or worsened (1/2 cases). Of the identified ENI-related medications used prior to formula switch, complete data was available for 8/10 patients. Of these, 4/8 patients had a reduction or discontinuation in medications after switch. Switching to 100% whey PBD was associated with improved feeding tolerance in this small cohort of patients experiencing ENI. These results are promising; however, additional trials are needed to better understand the true benefits.

Author(s):

Bethany Hopkins^1*, Maureen Huhmann², Seletha Periman³, Sarah S. Cohen⁴ and Jean Chouinard4

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