Enteral Nutrition and Gastrointestinal Intolerance. When Should We Be Concerned?

Enteral nutrition (EN) is a common medical therapy delivered in both the hospital and home setting. The importance of establishing enteral access, initiating EN early, and maintaining EN therapy has been well supported in a number of clinical investigations, especially in the intensive care unit (ICU).1The signs and symptoms of gastrointestinal (GI) intolerance associated with enteral feeding include nausea, vomiting, bloating, and diarrhea. These symptoms play a major role in the clinical decision of when to initiate EN or when to hold or terminate EN therapy once it has been initiated. In clinical practice, the delivery of EN is often interrupted by perceived intolerance to tube feeding.2 Unfortunately, there is no consistent symptom assessment tool that would aid the clinician in deciding when it is appropriate to withhold tube feeding because of these GI symptoms.