Diarrhea management in hospitalized adult patients undergoing enteral nutritional therapy: an integrative literature review

Abstract

Considering that diarrhea is a multifactorial and difficult-to-control complication frequently identified in hospitalized patients undergoing Enteral Nutritional Therapy (ENT), the objective of this study was to review the available literature, scientific evidence on strategies for the management of diarrhea in hospitalized adult patients and Submitted to NET. It is an integrative review carried out in six stages in the period from March to December 2021. The research was conducted through an electronic search for scientific articles without data restrictions, not a portal of newspapers from the Coordination of Improvement of People of Higher Level (CIPHL) of the Ministry of Education (ME) that covers 126 databases. The following stages are constituted by the categorization and evaluation of the studies, the interpretation of the results and the synthesis of the knowledge. The search initially resulted in a total of 596 studies and 95 abstracts foram selected, 25 foram submitted to critical analysis of the full text, and nine articles foram included for data extraction. The results of the studies suggest that there are various causes of diarrhea in hospitalized patients, the consistent management of this complication in most cases, can be improved with the use of a systematized protocol, with early start of enteral feeding administered by continuous or preferably intermittent infusion in 24 hours, and use of standard formula enriched with soluble fibers and/or probiotics and Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols (FODMAP's). However, there are still gaps in the literature on conclusive recommendations in specific populations.