Effects of Adding Blenderized Tube Feeds to Commercial Enteral Formulas on Gastrointestinal Symptoms in Adult Patients Receiving Enteral Nutrition

Background and Objectives: Accumulating evidence suggests that blenderized tube feeds (BTFs) may be generally well tolerated from a gastrointestinal (GI) perspective. Previous studies, predominantly conducted in pediatric populations, have reported improvements in symptoms such as gagging, retching, emesis, diarrhea, and vomiting following the transition from commercial enteral formulas (CEFs) to BTFs. However, data in adult populations remain limited. The primary objective of the present study was to investigate the association between different types of enteral feeds and gastrointestinal tolerance in adult patients receiving enteral nutrition. Materials and Methods: A prospective observational cohort study design was employed. Data were collected using a structured questionnaire, assessing parameters including recent medical history, weight changes, anthropometric characteristics, biochemical markers, gastrointestinal symptoms, and stool characteristics at baseline and after 30 days of enteral nutrition (EN). Participants (n = 60) were stratified into two groups: (i) the CEF group, receiving exclusively commercial enteral formulas, and (ii) the CEF–BTF group, receiving a combination of commercial formulas and blenderized tube feeds. Results: The mean body mass index (BMI) of the participants was within the normal range (21.7 ± 3.9 kg/m2). The prespecified primary outcome (total GSRS score at 30 days) did not differ significantly between groups. At 30 days following EN initiation, the CEF group reported significantly higher median discomfort scores for diarrhea [4 (1–5)] and loose stools [4 (1–4)] compared with the CEF–BTF group [1 (1–2)] and [1 (1–1.5)], respectively (r = 0.396; p = 0.016 and r = 0.485; p = 0.016). Additionally, stool consistency differed significantly between groups. Participants in the CEF group were more frequently classified as having loose stools, and participants in the CEF-BTF group were more frequently classified as having normal or hard stools (Cramer’s V = 0.493; p = 0.003). Conclusions: In conclusion, the findings of the present study suggest that the inclusion of BTFs may be associated with improvements in specific gastrointestinal outcomes compared with commercial enteral formulas alone in adult patients receiving enteral nutrition. Nevertheless, the current body of evidence remains heterogeneous and inconclusive, likely reflecting the multifactorial nature of gastrointestinal symptoms in this population. Further research, particularly well-designed randomized controlled trials in adult cohorts, is warranted to elucidate the impact of enteral feeding modalities on gastrointestinal outcomes.