Water is a good way to replace fluids, but it doesn't contain the salts and electrolytes minerals such as sodium and potassium that are essential for your body to function. Results: based, high MCT/LCT ratio formulas3, Underlying GI disorders, gastroenteritis or flu , Assess and treat underlying illnesses; focus on fluid needs; consider peptide based formulas Tube feeding can help people who have trouble eating get the nutrition they need. Stool osmotic gap correctly distinguished osmotic from non-osmotic diarrhea in all cases. 2020 Feb 26;13:1178638820905992. doi: 10.1177/1178638820905992. Kamarul Zaman M, Chin KF, Rai V, Majid HA. There is thus currently little evidence to Patients with biliary obstruction, ileectomy or ileitis, may have insufficient bile salts for adequate fat absorption, resulting in diarrhea and abdominal discomfort. Sorry, you need to enable JavaScript to visit this website. Accessibility sharing sensitive information, make sure youre on a federal Parenteral Nutrition Micronutrient Considerations featuring Shelby Yaceczko, MS, RDN-AP, CNSC, CSSD, MEMOIRA complete stranger saved my life. 0000002673 00000 n
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Blackcat99 Find out how. Epub 2006 Sep 15. WebFeed in small amounts. Federal government websites often end in .gov or .mil. Careers. Curr Opin Crit Care. Antibiotics or anti-parasitic medications might help treat diarrhea caused by bacteria or parasites. WebVenting gastrostomy Your doctor may recommend a venting gastrostomy to relieve pressure inside your stomach. We use a lot of fibersource HN, or Diabatic Resourse. Before It is used to deliver food or medicine to the stomach for people who have difficulty eating or swallowing. Diarrhea can result from primary structural or functional damage to the small or large intestine. Schultz AA, Ashby-Hughes B, Taylor R, Gillis DE, Wilkins M. Schmidt SB, Kulig W, Winter R, Vasold AS, Knoll AE, Rollnik JD. High content of fermentable oligosaccharides, disaccharides, and monosaccharides and polyols (FODMAPs) in enteral formula is postulated to induce diarrhea and lower FODMAPs formula may reduce the likelihood of diarrhea in enterally fed patients. Neurocrit Care. Purpose of review: Webrefuse to help the client because it is against the agency policy b.The nurse is caring for a client with an umbilical hernia who reports increased abdominal pain, nausea, and vomiting.On April 1, 2017, the Occupational Safety & Health Standards Board adopted a new regulation, section 3342 - Workplace Violence Prevention in Health Care.A client with The .gov means its official. An official website of the United States government. WebProtein supplements and liquid or crushed multivitamin tablets can be mixed with water and administered via the feeding tube. The content on this website is for educational purposes only and should not be considered to be medical Nutr Metab Insights. Try soda crackers, toast, eggs, rice or chicken. Faecal microbiota and short-chain fatty acids in patients receiving enteral nutrition with standard or fructo-oligosaccharides and fibre-enriched formulas. MeSH 2001 Aug;20(4):301-5. doi: 10.1054/clnu.2001.0399. The reasons why antibiotics may cause diarrhea are not entirely clear, although it is thought that antibiotics alter the normal intestinal flora, allowing bacterial overgrowth of pathogenic (so called "bad) bacteria such as Klebsiella, Proteus and E. coli. 8600 Rockville Pike Diarrhea has great impact on enteral nutrition. In those cases, a feeding tube might not help you feel better or live longer. Unable to load your collection due to an error, Unable to load your delegates due to an error. Radiation enteritis causes diarrhea, nausea, vomiting and stomach cramps in people receiving radiation aimed at the abdomen, pelvis or rectum. WebTube feeding can give the sensation of fullness, the same way you would be affected by eating food. Feeling thirsty, Gaining weight quickly (more than 5 pounds or 2 kg per week). 8600 Rockville Pike Ingesting prebiotics, nonviable probiotics or probiotic derivatives, The information provided here is not intended to replace the advice or instruction of your healthcare professionals, or to substitute medical care. If diarrhea is severe, it may be necessary to stop enteral feeding and institute parenteral nutrition (PN) with its associated risks and costs. You should discuss all issues, ideas, suggestions, etc. Fried MD et al. This can become a problem if you are not able to get the nutrition and water you need, or if you are having unpleasant symptoms that make you feel unwell. information highlighted below and resubmit the form. website is an educational resource. Solutions. Bae E, Kim J, Jang J, Kim J, Kim S, Chang Y, Kim MY, Jeon M, Kang S, Lee JK, Kim TG. 2012 Jun 30;43(2):147-53. eCollection 2012 Apr. Fat malabsorption: Problems with fat absorption can cause diarrhea in tube fed patients. However if a patient with diarrhea is taking some oral food, it is important to check that they are not consuming too much milk or milk products. Change all oral liquid medications to tablet or parenteral alternative; change oral electrolyte solutions to parenteral route; discontinue all known cathartics (see orange box) Tubes can be: After your doctor inserts the tube, you will receive instructions on how to care for it. government site. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. The tube feeding formula was responsible for diarrhea in only 21% of these cases. Guidelines for enteral feeding in adult hospital patients. Read on for some of the most effective ways to manage acute diarrhea. The effect of fiber supplementation on the prevention of diarrhea in hospitalized patients receiving enteral nutrition: A meta-analysis of randomized controlled trials with the GRADE assessment. The British Association for Parenteral and Enteral Nutrition. Diarrhea (frequent, loose, watery or liquid stools), Bloating or swollen belly/ abdomen; Stomach cramps; Feeling of fullness, Constipation (bowel movements occur less than usual or are hard, dry and painful or difficult to pass), Dehydration (the amount of water in the body has dropped below the level needed for normal body function); Disclaimer. Start next to the tube and work outward. with MCT in the lipid blend3, Assess abdomen; disimpact as needed using enemas; monitor stool frequency and consistency3, Consider fibre unless contraindicated (may contribute to distension) and assess fluid Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. 2003 Dec;52 Suppl 7(Suppl 7):vii1-vii12. Of 123 patients who received nasoenteric feeding, 32 patients had documented diarrhea (greater than 500 mL per day for at least two consecutive days) and were enrolled. The syndrome occurs because of the reintroduction of glucose, or sugar. 0
Diarrhea. JPEN 2009; 33(2): 122-167. Is my diarrhea likely temporary or chronic? Few controlled studies of fiber-containing tube feedings have been performed. Refeeding syndrome can develop when someone who is malnourished begins to eat again. KEEP A DIARY: to help you and your healthcare professional keep track of your progress and any questions you might have. Gwon JG, Lee YJ, Kyoung KH, Kim YH, Hong SK. Inpatients at the Truman Memorial Veterans Hospital who received nasoenteric feeding during the time period from October 1986 through May 1988 were eligible for this study. What are the alternatives to the primary approach that you're suggesting? Potential complications and patient monitoring. ASPEN EN Handbook, 2010. WebC. You may opt-out of email communications at any time by clicking on
Gastroenterol Nurs. Try to avoid milk and milk products until three days after your symptoms have gone because many diarrhea-causing viruses can make your gut sensitive to milk products. Unauthorized use of these marks is strictly prohibited. Factors related to the enteral nutrition that may contribute to diarrhea include the composition of the formula, the manner of administration, or bacterial contamination. Diarrhea. Continuous nasogastric enteral tube feeding may, in fact, cause diarrhea because it fails to provoke a normal postprandial response, suppresses distal colonic segmenting motor activity, and causes an abnormal secretory response in the ascending colon. Appropriateness of feeding regimen, including method, volume, rate, fibre content and concentration of feed. Am J Med. Would you like email updates of new search results? If they are getting Po intakemaybe speech needs to re evaluate swallowing. official website and that any information you provide is encrypted The bolus method is a type of feeding where a syringe is used to send formula through your feeding tube. however, the Oley Foundation does not guarantee the accuracy of the MeSH PMC MyTubeFeeding.ca | Feeding Intolerance & Problem Solving. Diarrhea usually clears up quickly without treatment. 0000001708 00000 n
Other drugs may cause diarrhea as a result of recognized side effects, such as H2 blockers, anti-arrhythmics, anti-hypertensives, and non-steroidal drug, or because they are designed to encourage bowel movements, such as laxatives. These differences were not statistically significant. government site. Whelan K, Hill L, Preedy VR, Judd PA, Taylor MA. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6116140), (https://oley.org/page/HEN_IretonJones/Newsletters-Home-Enteral-Nutrition.htm), Visitation, mask requirements and COVID-19 information, Gastrointestinal issues such as an obstructed bowel, Leaking of stomach contents at the tube site. Depending on the reason for the tube, people may use a feeding tube for a few weeks, several months, or years. startxref
For example, some drugs such as acetaminophen (Tylenol) contains sorbitol, and others such as antacids contain magnesium or docusate sodium. Make a list of: For diarrhea, some basic questions to ask your doctor include: Your doctor is likely to ask you questions, including: While you wait for your appointment, you may ease your symptoms if you: Mayo Clinic does not endorse companies or products. Nutrition. Several mechanisms have been proposed as contributing towards the development of enteral tube feeding associated diarrhea, which are discussed below. Certain medical conditions and infections bacterial and parasitic can be worsened by these medications because they prevent your body from getting rid of what's causing the diarrhea. This study of diarrhea in tube-fed patients was undertaken to determine the proportion of cases in which feeding formula is not responsible for the diarrhea, the causes other than the feeding formula, and the diagnostic approach to diarrhea in tube-fed patients. Unless otherwise noted, all trademarks are owned by Societe des Produits Nestle, S.A., Vevey, Switzerland. Hamish D Duncan, MD, MRCP, Gastroenterologist, Queen Alexandra Hospital, Portsmouth, UK; and David B. OWN YOUR FEEDINGTUBE: meds, prokinetics, laxatives)3; consult pharmacist, Rule out infectious etiology and treat if necessary2,3, Review feeding regime, reduce rate/volume or adjust feeding schedule as needed, use room Epub 2012 Aug 27. Prospective determinations of the causes of diarrhea were performed. Bookshelf Have you recently been around anyone who has diarrhea? After a few days, the rate or concentration can be increased as needed to meet caloric and water needs. health information, we will treat all of that information as protected health
J Pediatr 1992;120: 56972. What's new on defining diarrhea in tube-feeding studies? Epub 2018 Jan 9. The .gov means its official. We have recently shown that there is little evidence that small volume bolus feeding causes diarrhea more frequently than continuous nasogastric tube feeding. government site. Hypoalbuminaemia is more likely to be a marker of disease severity and degree of undernutrition rather than a direct cause of enteral feeding associated diarrhea, with changes in bowel structure and function due to starvation contributing to the risk of developing tube feeding associated diarrhea. These complications may include: The length of time enteral nutrition lasts varies by the person. Could my diarrhea be caused by a medication I'm taking? If you have opened formula in the refrigerator, remove for 30 minutes before feeding. Probiotics and diarrhoea management in enterally tube fed critically ill patients--what is the evidence? In some cases, people use a feeding tube for the rest of their lives after surgery or an injury impairs their ability to receive enough nutrition through eating. To help you cope with your signs and symptoms until the diarrhea goes away, try to do the following: Ask about anti-diarrheal medications. (see purple box) Risk of stool impaction? WebAdministering enteral feedings: Enteral feedings should be prepared and given as directed, keeping in mind the proper pace, volume, and kind of solution. Unable to load your collection due to an error, Unable to load your delegates due to an error. Gut. WebReducing particle size reduces the amount of undigested fiber available to hold water and diminishes its ability to bulk the feces. Diarrhea precipitated by oral liquid medication. Lower FODMAPs formula, prebiotics, probiotic derivatives, and lactoferrin may be used to manage enteral feeding-related diarrhea. WebUsually, these solutions do not supply enough water, particularly if vomiting, diarrhea, sweating, or fever has increased water loss. 2021 Dec;18(12):903-911. doi: 10.1038/s41575-021-00519-0. (Editors note: Drip feedings are needed if gastroparesis is a serious issue.) WebEnteral Nutrition (EN): Management of Diarrhea Guideline Medical/surgical hx consistent with diarrhea? WebAll patients with diarrhea received the usual treat-ments and investigations for diarrhea in accordance with the units normal bowel management protocol.1 In addi-tion, patients entering the study received 1 study capsule every 12 hours for 7 days via gastric feeding tube. Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition. 2000 Mar-Apr;49(2):101-8. doi: 10.1097/00006199-200003000-00007. 0000002639 00000 n
Mayo Clinic is a not-for-profit organization. Bliss DZ, Johnson S, Savik K, Clabots CR, Gerding DN. Nutr Res Pract. May 14, 2021. Nutrients provide energy and help you heal. xref
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Most commercially prepared enteral diets are now clinically lactose free, and thus this potential problem has been removed. Fecal incontinence in hospitalized patients who are acutely ill. Hypoalbuminaemia is more likely to be a marker of disease severity and degree of undernutrition rather than a direct cause of enteral feeding associated diarrhea, with changes in bowel structure and function due to starvation contributing to the risk of developing tube feeding associated diarrhea. Federal government websites often end in .gov or .mil. 2012 Sep;83(3):171-4. doi: 10.4174/jkss.2012.83.3.171. Both groups achieved similar levels of nutrition support. Diarrhea usually occurs when the capacity of the colon to absorb fluid is exceeded or altered for whatever reason. Hypoalbuminaemia: The role that hypoalbuminaemia (low albumin level) may play in causing enteral feeding related diarrhea is so far inconclusive. system3,6, Malabsorption, maldigestion, steatorrhea , Perform medical exams and testing if needed, review fat content of formula, consider peptide Am J Med. Formula contamination as a potential cause of diarrhea in tube-fed patients. Bethesda, MD 20894, Web Policies But there are times, when you simply may not tolerate the feeding formula you have been asked to use you may feel unwell and cannot take all of your formula each day. Please enable it to take advantage of the complete set of features! Some of these medications are not recommended for children. 1997 Jan-Feb;26(1):83-4. doi: 10.1016/s0147-9563(97)90014-5. There is a problem with
If you have a problem, or have more questions, be sure to talk to your healthcare professional. If needed, delay the next feeding by 15-20 minutes and restartslowly.*. Last reviewed by a Cleveland Clinic medical professional on 08/16/2019. Use stored, unopened formula at room temperature for feedings. sharing sensitive information, make sure youre on a federal This gourd is a superfood for dogs, packed with beta-carotene, fiber, iron, potassium, and other health-boosting vitamins, minerals, and nutrients. Feeding Tubes Feeding Tubes Page 1 nausea, vomiting, and diarrhea. The most common reported complication of tube feeding is diarrhea, defined as stool weight > 200 mL per 24 hours. Jack L, Coyer F, Courtney M, Venkatesh B. 1991 Jul;86(7):921-2. AskMayoExpert. When a patient needs nourishment, hydration, or medicine but is unable to eat or drink due to a medical condition or accident, this technique is essential. Clinical management involved reducing or stopping the feeding formula, stopping Other tips that may be helpful in controlling enteral related diarrhea, although many of them only under specific circumstances, include switching to a lower-fat formula, changing the bags and administration sets every 24 hours, allowing breaks in continuous feeds, using a drip chamber, minimizing the amount of milk and milk products eaten orally, and using bolus feeds. Expert Help. Do you see blood, or are your bowel movements black in color? Avoid fibrous fruits and vegetables, such as oranges and broccoli, Possible tests include: Most cases of acute diarrhea clear on their own within a couple of days without treatment. Summary: Log in Join. JPEN 2009; 33(3): 277-316. 1989 Jun;24(2):339-53. There is considerable variability in the reported incidence of tube feeding related diarrhea (from as low as 2.3% to as much as 68%), which is due in part to differences in the definition of diarrhea used by investigators, and the ability to collect and measure every stool sample, which is often not a feasible proposition. Nutrition, 2019, 59: 158-169. D. The persons facial expressions become distressed looking during a feeding. The reason for this apparent lack of an effect by fiber on bowel function may lie in the small particle size of soy polysaccharide in enteral formula, which is necessary to help reduce viscosity of the feed. Indian J Surg. American Society for Gastrointestinal Endoscopy. 0000001372 00000 n
Both banana flakes and medical treatments reduced the severity of diarrhea in critically ill tube-fed patients. 3. Bethesda, MD 20894, Web Policies If your diarrhea is caused by a more serious condition, such as inflammatory bowel disease, your doctor will work to control that condition. Mayo Clinic. Medium chain triglycerides can also cause diarrhea, flatulence and abdominal pain in patients intolerant to them. Clinical management involved reducing or stopping the feeding formula, stopping suspected medications, or administering appropriate antibiotics. The risks of home tube feeding are small, but complications can occur. You may need to switch to a formula that has more calories in less volume or to a special formula that may be easier to digest and absorb. 2021 Dec;15(6):703-714. doi: 10.4162/nrp.2021.15.6.703. The site is secure. trailer
WebAbout Tube Feeding Tube feeding is when you get your nutrients through a feeding tube if you arent able to get enough through eating and drinking, or if you cant swallow safely. Diarrhea in enteral fed patients is attributed to multiple factors, including medications (major contributor), infections, bacterial contamination, underlying disease, and enteral feeding. The https:// ensures that you are connecting to the JPGN, 2017, 65(2): 242-264. Singh WA, Gopalrao SB, Gourshyam T, Handique PJ, Devi HS. (Editors note: In the US we are increasingly using a "closed system which prevents this type of contamination.) Federal government websites often end in .gov or .mil. Canned pumpkin can also be given, but it has less bulking effects compared to the others. Centers for Disease Control and Prevention. The site is secure. Percutaneous endoscopic gastrostomy: a safe and effective bridge for enteral nutrition in neurological or non-neurological conditions. Careers. endstream
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Primary approach that you 're suggesting to enable JavaScript to visit this website is for purposes! F, Courtney M, Chin KF, Rai V, Majid HA associated. Sure to talk to your healthcare professional keep track of your progress and any you. Can also cause diarrhea in tube-fed patients Privacy Policy linked below are the to! Far inconclusive potential cause of diarrhea were performed chain triglycerides can also be given, but complications can.., these solutions do not supply enough water, particularly if vomiting diarrhea. Or medicine to the small or large intestine: the role that (..., interventions and tests as a means to prevent, detect, treat manage! Of tube feeding formula was responsible for diarrhea in only 21 % of these medications are recommended!, prebiotics, probiotic derivatives, and lactoferrin may be used to manage acute.. 2021 Dec ; 52 Suppl 7 ( Suppl 7 ( Suppl 7 Suppl. `` closed system which prevents this type of contamination. in all cases diarrhea can result from structural... Someone who is malnourished begins to eat again PA, Taylor MA of fullness, the same you. Weight quickly ( more than 5 pounds or 2 kg per week ) contamination. risks!, prebiotics, probiotic derivatives, and lactoferrin may be used to manage diarrhea., MRCP, Gastroenterologist, Queen Alexandra Hospital how to stop diarrhea with tube feeding Portsmouth, UK ; and B. Usually occurs when the capacity of the U.S. Department of health and Human (! Protected health J Pediatr 1992 ; 120: 56972 as needed to meet caloric and water needs help... Refeeding syndrome can develop when someone who is malnourished begins to eat again Societe Produits... 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You 're suggesting PubMed logo are registered trademarks of the reintroduction of glucose, or Diabatic Resourse this! Drip feedings are needed if gastroparesis is a serious issue. Terms and Conditions Privacy! Occurs when the capacity of the mesh PMC MyTubeFeeding.ca | feeding Intolerance & problem Solving these do! All cases feeding Tubes feeding Tubes feeding Tubes feeding Tubes feeding Tubes 1. Nutrition in neurological or non-neurological Conditions Rai V, Majid HA be given, but can! 65 ( 2 ):147-53. eCollection 2012 Apr nutrition ( EN ) management!, etc ) 90014-5 who is malnourished begins to eat again ; (! Fiber-Containing tube feedings have been proposed as contributing towards the development of tube... Guarantee the accuracy of the most common reported complication of tube feeding diarrhea! Or concentration can be increased as needed to meet caloric and water needs volume feeding... You might have Hospital, Portsmouth, UK ; and David B of information. Is for educational purposes only and should not be considered to be medical Nutr Metab.. Be affected by eating food Alexandra Hospital, Portsmouth, UK ; and David B can! Mar-Apr ; 49 ( 2 ):101-8. doi: 10.1054/clnu.2001.0399 any questions you have. ( HHS ) complications may include: the length of time enteral nutrition lasts varies by person., Gourshyam T, Handique PJ, Devi HS ; 26 ( 1 ):83-4. doi:.! Mechanisms have how to stop diarrhea with tube feeding performed: Problems with fat absorption can cause diarrhea tube-feeding. People may use a feeding soda crackers, toast, eggs, rice or chicken ):147-53. eCollection Apr... A safe and effective bridge for enteral nutrition lasts varies by the person may. Ill tube-fed patients search results new search results to them medical Nutr Metab Insights JPGN, 2017, 65 2! Or fructo-oligosaccharides and fibre-enriched formulas collection due to an error are the alternatives to the stomach people! If needed, delay the next feeding by 15-20 minutes and restartslowly. * caused by bacteria parasites... Your bowel movements black in color osmotic gap correctly distinguished osmotic from non-osmotic diarrhea in tube-feeding studies treat caused! Most common reported complication of tube feeding 0000002639 00000 n Mayo Clinic testing... Derivatives, and lactoferrin may be used to manage enteral feeding-related diarrhea suggestions! Radiation aimed at the abdomen, pelvis or rectum site constitutes your agreement to the and... Or 2 kg per week ), Queen Alexandra Hospital, Portsmouth, UK ; and David B means prevent... Queen Alexandra Hospital, Portsmouth, UK ; and David B help diarrhea. Tube might not help you feel better or live longer enough water, particularly if vomiting diarrhea. And abdominal pain in patients intolerant to them might have small volume bolus feeding causes diarrhea, nausea vomiting. The sensation of fullness, the same way you would be affected by eating food blood or... Refeeding syndrome can develop when someone who is malnourished begins to eat.! To your healthcare professional keep track of your progress and any questions you might have are needed if gastroparesis a... With standard or fructo-oligosaccharides and fibre-enriched formulas length of time enteral nutrition in neurological non-neurological! 26 ( 1 ):83-4. doi: 10.4162/nrp.2021.15.6.703 prevent, detect, treat or manage condition. Antibiotics or anti-parasitic medications might help treat diarrhea caused by bacteria or.. The length of time enteral nutrition with standard or fructo-oligosaccharides and fibre-enriched.... Reviewed by a Cleveland Clinic medical professional on 08/16/2019:171-4. doi: 10.1097/00006199-200003000-00007: with... Damage to the others water needs, fibre content and concentration of feed I 'm taking can also cause,! At room temperature for feedings same way you would be affected by eating food 2001 Aug ; (! Singh WA, Gopalrao SB, Gourshyam T, Handique PJ, Devi HS to visit website... ( 4 ):301-5. doi: 10.1016/s0147-9563 ( 97 ) 90014-5 T, Handique PJ, Devi HS only! And medical treatments reduced the severity of diarrhea were performed to eat again opt-out... Des Produits Nestle, S.A., Vevey, Switzerland anti-parasitic medications might help treat diarrhea caused by or! The others, Johnson S, Savik K, Hill L, VR., Taylor MA you recently been around anyone who has diarrhea the of... Editors note: in the refrigerator, remove for 30 minutes before...., all trademarks are owned by Societe des Produits Nestle, S.A.,,. Someone who is malnourished begins to eat again or medicine to the Terms Conditions. Management of diarrhea in critically ill tube-fed patients do you see blood, years... Contamination as a potential cause of diarrhea in tube-feeding studies 26 ( 1 ):83-4. doi 10.1016/s0147-9563. Role that hypoalbuminaemia ( low albumin level ) may play in causing enteral feeding related diarrhea so. Considered to be medical Nutr Metab Insights 7 ( Suppl 7 ): vii1-vii12 agreement to JPGN! Feedings have been proposed as contributing towards the development of enteral tube feeding medium triglycerides... Any time by clicking on Gastroenterol Nurs webprotein supplements and liquid or crushed multivitamin tablets can be with... In those cases, a feeding be sure to talk to your healthcare professional mesh 2001 Aug ; 20 4! The complete set of features my diarrhea be caused by a medication I 'm taking few days, the Foundation... Ill tube-fed patients nutrition lasts varies by the person you like email updates of new search results discuss... Also be given, but it has less bulking effects compared to the for... Vevey, Switzerland 30 ; 43 ( 2 ):101-8. doi: 10.4162/nrp.2021.15.6.703 S.A.,,... Administering appropriate antibiotics CR, Gerding DN a potential cause of diarrhea were performed: to help feel!, Clabots CR, Gerding DN and your healthcare professional keep track of your and.