Tube Feeding and Diarrhea

Amy Long Carrera, MS, RD, CNSC, CWCMS
Registered Dietitian Nutritionist
10/19/11  7:00 AM PST
African american woman at home with hand on stomach because indigestion, painful illness feeling unwell. Ache concept.

Overview

According to the Academy of Nutrition and Dietetics, diarrhea is one of  the most commonly reported gastrointestinal complications of tube feeding. Many potential causes exist for the development of loose stools when you are on tube feeding, as well as many potential solutions. Choosing the right solution for tube feeding and diarrhea can help resolve your symptoms rather than make them worse.

Background

Enteral nutrition or tube feeding, is liquid food given through a tube into the stomach or small bowel, states the American Society for Parenteral and Enteral Nutrition (ASPEN). In 1995, Medicare and its beneficiaries spent $660 million dollars on enteral nutrition products. MedlinePlus defines diarrhea as more than three large, watery stools per day. You may also have abdominal cramps, bloating and a feeling of urgency if you experience tube feeding and diarrhea.

Potential Causes of Tube Feeding and Diarrhea

Medications that may contribute to loose stools include antibiotics, liquid medications in a sorbitol base, magnesium-containing antacids, and potassium and phosphorus supplements, states the Oley Foundation. Many drugs in liquid form have a high osmolality, or number of particles that can lead to diarrhea. Gastrointestinal infections can irritate the intestine and lead to watery stools. Formula contamination caused by improper handling and storage can also induce diarrhea, cautions the Oley Foundation.

Solutions and Prevention

Ask your doctor or pharmacist if any of your medications could contribute to loose or watery stools. Sometimes changing the form that your medication comes in can help. Use good hand washing techniques, wash all equipment with warm water and check formula expiration dates. Use one feeding bag for no more that 48 hours and hang formula for no more than eight to 12 hours. If diarrhea develops after taking antibiotics, check with your doctor before taking antidiarrheal medication.

Immediate Action

Try lowering the rate of tube feeding until diarrhea improves. Stopping completely may contribute to dehydration and electrolyte loss. Contact your doctor if you notice a large increase in diarrhea or if it lasts for more than 24 hours. You should also call your doctor if there is blood in your stool or if you experience severe abdominal pain.

Other Considerations

Try adding a soluble fiber product to your daily tube feeding regimen or switching to a fiber-containing formula to help make your stools more formed. Consider using probiotics, recognized by the National Center for Complementary and Alternative Medicine as effective in treating diarrhea. Most people can stay on standard tube feeding formulas, which are generally isotonic, lactose-free, low in fat and well tolerated, states ASPEN.

The recommendations provided in this material are not intended to replace the medical advice of a physician. Contact your healthcare professional for personal medical advice or diagnosis-related questions and treatment. If you think you have a medical emergency, call 911.

For more information, see related articles and feeding tube resources here:

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Comments

28 comments

  1. Concerning your recommendation to use probiotics in treating diarrhea while using a g-tube: I have been warned that probiotics should not be given through a stomach g-tube because they contgain live yeast spores that could get into the bloodstream and cause a systemic fungus problem.
    The pharmacist at Florastor did not recommend giving Florastor through a stomach feeding tube for this reason. My husband is suffering from diarrhea after antibiotics, and his doctor wants him to take probiotics. What probiotics, then are indicated for a stomach g-tube, ones that will do him no harm. Products, such as Protonix, are supposed to be made for g-tube delivery, but the tiny beads get stuck in the tube and are useless and dangerous because they clog up the tube. Please, I need some advice in this situation. Thank you.

  2. I am a health care professional, and I enjoyed the helpful information written in the article. Digestive health and Nutrition are in fact important in the overall well being and healing of patience.

  3. I just got a feeding tube have not starting uses it yet but I was cleaning around it and was going to flush it out and it seem like it was fetus with mucus in my feeding tube is it ok to still use the tube for feeding and is this dangerous with the fetus going though.

  4. Hello,
    I have been waiting for an appointment from the VA for my Dad for follow up. He has a Peg now, gets diarrhea, can I use a Gastroenterologist to manage his feedings and diarrhea?

  5. My mama is fed with tube (nose). She takes Nutrison Multi Fibre 1.0 kcal/ml. Since one week she has diarrhea, lot of mucus and she pains. She even got fever Doctor gave bioflor but no change. Could you suggest me something efficient. Thanks.

  6. I found this article to be extremely accurate and informative. I happened to stumble upon this article while doing research for an initiative that I Hope will implemented at the hospital where I work. Since you are very well versed in GI, would it be possible to contact you via email and pick your brain a bit? I saw your email address in a previous comment, but I’d prefer to ask permission rather than to assume it was meant for anyone to use.
    Thank you!

  7. I know not a lot of people do this but my dig is on a stomach feeding tube now for 9 weeks, she is doing great but has diarrhea I can nit get rid of please help me.. Teresa

  8. I provide some care for my mother who has been using primarily enteral feeding for more than 5 years. Her health has been in decline since late January rendering her 100% reliant on her tube for nutrition. She has lost 16lbs in 10 weeks, (about 13%of her total weight) is down to 3 cans of formula per day (1050 cals) and has been experiencing fecal incontinence, urgent diarrhea and as of 3 days ago, pale stools. A visit to the ER for dizziness last week resulted in numerous scans which showed nothing. The ER concluded she is suffering from malnutrition. Where and how do I help her? She is non verbal as a result of oral cancer surgery and reluctant to pursue further intervention. I am at a loss. Her ER visit, Gastroenterologist and GP do not address her nutrition. Is there a specific kind of dietician who works with tube fed elderly adults? I’m struggling!
    Any guidance would be appreciated.

  9. Hello. I have read all the post and wonder if some one could help. My mom is on a PEG tube. Her stomach is always hurting when she eats. Today I got her some tylenol for her pain and we giving it to her when her stomach started hurting as I’m administrating the tylenol in her tube and then 4 hrs later she starts having bouts of diarrhea. Could the tylenol of caused this? I asked a pharmacist about it before giving it to her.Please help.

  10. So my son just got a replacement for his GJ tube yesterday. I took him to the ER to get the replacement, it’s nice and clean and brand new but since this morning at 5:48 then he had a bowel movement at 845 and then 1130am then another one at 2:05pm. The rate of his feeding is only at 68ML. But the last time he had bowel movement was Monday night 1106pm prior to today due to clogging of his feeding tube. I had to take him to the ER yesterday morning to get a replacement GJ feeding tube. Could I give him something to slow it down or should I bring his feeding rate to a lower ML? He has issues with having regular bowl movements already they’re always running due to only intake of 2 Cal formula and water through tube he is on his feeding 12 hours a day. He been on his feeding since 930am but I stop it for at 220pm to see how he doing. Any suggestions?

  11. My grandmother has a feeding tube in which she has been using for a month and she’s having extreme Diarrhea at the moment. I would like to know as she has chronic gastritis could that be the cause or is there another problem ?

  12. My husband has had a PEG tube for over year due to an operation for Oral Cancer. He cannot take anything by mouth at all.
    After the first or second feed of the day he has to rush to the toilet with diarrhoea about four times. The rest of the day he is OK. He has 200mls of Nutrison Energy seven times a day as instructed by the Dietician.
    This is very draining for him making him rather scared to leave the house.
    Any advice please.
    Thank you.
    Sue

  13. Hi my mother have a peg tube for over a year and now she have diarrhea really bad as soon as she have her nutren 1.0 fiber it run right out her we have change it shy was on 1.5 I have tried everything over the counter and nothing works the doctor run test she don’t have c-diff so what can I do any suggestions will help thanks

  14. Bloating in lower bowel 4 hours after feed stopped on my j-tube. My bowles are usually regular but just feel swollen and bloated, have had some laxatives to help, if it can.

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