association between medication use and adverse gastroenterologic events in patients receiving enteral nutrition therapy at a university hospital

Introduction: Enteral Nutrition Therapy (ENT) is considered an important tool for the appropriate maintenance of nutritional conditions. ENT tolerance may be limited due to gastrointestinal (GI) events resulting from formula composition and/or simultaneously administered drug therapies. Aims: To verify the possible association between GI events and drug therapies being administered to patients receiving ENT at a university hospital. Methods: A prospective observational cohort study was conducted. Medical records from 95 patients requiring ENT at the Hospital de Clínicas de Porto Alegre (HCPA) were randomly evaluated until discharge, death, or initiation of oral or parenteral diet occurred. Details of the administered medications and enteral formula, together with the presenting patient disease and digestive manifestations, were recorded by the medical team. Three experienced gastroenterologists evaluated the possible association between the digestive symptoms and the medications employed. The study protocol was approved by the HCPA Research Ethics Committee and patient consent forms were signed. Results: Mean patient age: 65 ± 17 (24-95) years; 94.70% presented with GI events: constipation 70.50%, diarrhea 38.90%, abdominal distension 18.90%, vomiting 16.80%, and pulmonary aspiration 1.10%. ENT was most indicated in neurologic (50.50%) and neoplastic (25.30%) disease. Medications given to the patients showed a positive relation: 63.20% to 86.70% of GI symptoms could be attributed to the drugs being administered. Conclusions: GI complications during ENT are common; they are frequently linked to administered drug therapy. Health care teams should consider all risk factors present, specifically those related to prescribed medication, before modifying/suspending ENT.