Leading article Colonic responses to enteral tube feeding

Enteral feeding has become an invaluable treatment in both the hospital and home setting. However, it is not without complications, the commonest of which is diarrhoea. This occurs in up to 25% of patients on general wards and 63% of patients on intensive care units. 5 Diarrhoea not only limits the eYcacy of enteral feeding, but also adds to potential complications, distresses both patients and staV, and increases costs. Until recently, its pathogenesis has remained unknown, although a number of factors have been implicated, including infected diets, lactose intolerance, concomitant antibiotic therapy, 10 osmotically active medications, 12 and co-existing hypoalbuminaemia. 14 However, despite attention to these factors, diarrhoea still occurs in up to 15% of patients. This would imply, therefore, that some other mechanism or mechanisms are involved.