Functional Oral Intake and Bowel Function in Enterally Fed Adults with Neurogenic Dysphagia: A Cross-Sectional Study

Background/Objectives: Gastrointestinal complications are common in enterally fed adults with neurogenic dysphagia. This study examined the association of functional oral intake with stool form and defecation frequency in this population. Methods: This prospective cross-sectional study included adults receiving enteral nutrition via a nasogastric tube or percutaneous endoscopic gastrostomy. Functional oral intake was assessed using the Functional Oral Intake Scale (FOIS), nutritional risk using the Nutritional Risk Screening 2002 (NRS-2002), and stool consistency using the Bristol Stool Form Scale (BSFS). Defecation frequency, daily fluid intake, enteral feeding duration, and feeding route were also recorded. Correlation and multivariable regression analyses were performed. Results: A total of 100 participants were included: 55 were classified as FOIS Level 1 and 45 as FOIS Levels 2–3. FOIS Level 1 was associated with hard versus normal stool (unadjusted odds ratio [OR] = 10.22, 95% confidence interval [CI]: 3.59–29.12; p < 0.001), with consistent adjusted and Firth estimates. The unadjusted association with soft/watery versus normal stool was nominally significant (OR = 3.17, 95% CI: 1.04–9.72; p = 0.043). Recorded fluid intake excluded formula water and was lower in FOIS Level 1, which entails no oral intake (p = 0.024). Defecation frequency differed between groups (p = 0.003). Conclusions: FOIS Level 1 was associated with hard stool, and defecation frequency differed between FOIS-defined feeding-status groups. Clinical differences between groups and unmeasured confounding limit interpretation. These findings are exploratory and hypothesis-generating and do not establish an independent or causal effect of FOIS status on bowel function.