Causes of diarrhea in tube-fed patients: a comprehensive approach to diagnosis and management.

In the absence of a standard definition for diarrhea, clinicians have developed their own descriptions, such as an increased frequency of stools, an increased quantity of water in the stool, an increased weight of the stool, or a change in the consistency of the stool. The clinician should first determine whether the diarrhea is osmotic or secretory. Diarrhea in patients who receive enteral nutrition is often caused by such conditions as diabetes, malabsorption syndromes, infection, gastrointestinal complications, or concomitant drug therapy instead of the enteral formula. Factors related to the enteral nutrition that may contribute to diarrhea include the composition of the formula, the manner of administration, or bacterial contamination. To ensure that the nutritional requirements of patients are met and the appropriate treatment is administered, all of the possible causes of diarrhea should be considered before discontinuing or reducing the amount of formula delivered.