P781
EFFICACY OF FIBER-ENRICHED VERSUS FIBER-FREE ENTERAL FEEDS ON BOWEL FUNCTION OF NON-CRITICALLY ILL TUBE-FED ADULT PATIENTS IN SAUDI ARABIA-A PROSPECTIVE COHORT STUDY
M. Abolfotouh1,2, R. alolayan3,*, H. Binhusain3, A. Alsayegh4, I. Al Babtain1,5
1King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia, 2Family Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt, 3Department of Clinical Nutrition, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, 4College of Applied Medical Sciences, King Saud University, 5Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
Rationale: There is controversy regarding whether using fiber-enriched formula affects the incidence of diarrhea among enterally fed patients. Also, there is a lack of clinical studies about enterally fed patients' tolerance for feeding and the incidence of diarrhea among patients in the Middle East.
Methods: This prospective cohort study of 55 fiber-free and 119 fiber-enriched tube-fed adult patients admitted for five or more days with medical or surgical conditions. Data on patients' demographics, antibiotics and laxative medications, and gastrointestinal complications were collected.
Results: The rate of diarrhea dropped from 55% for fiber free formula to 29% for fiber-enriched formula groups, with an absolute risk reduction of 25% (95% CI 24.6-25.6, p < 0.001) and relative risk reduction of 64%, and relative risks was 0.54, reflecting a decrease in the rate of diarrhea by 46% after fiber enrichment. The rate of significant weight loss dropped from 46% without enrichment to only 27% with enrichment, with an absolute risk reduction of 19% (95% CI: 18.0-19.2, p < 0.001) and relative risk reduction of 41%, and relative risks was 0.59, reflecting a 41% reduction in significant weight loss after fiber enrichment. After adjusting for some potential confounders, fiber free formula was a significant predictor of diarrhea (OR = 3.04, 95% CI 1.49-6.19, p = 0.002), and significant weight loss (OR = 2.37, 95% CI 1.16-4.84, p = 0.018) in tube feeding, while antibiotic intake was also a significant predictor of only diarrhea (OR = 2.68, 95% CI 1.12-6.38, p = 0.026)
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Conclusion: This study demonstrated the beneficial effect of fiber supplementation in minimizing diarrhea in hospitalized patients receiving tube feeding. Antibiotic usage must be scrutinized and stopped if possible.
Disclosure of Interest: None declared