Table 5.

Measures to prevent EN-related diarrhea

At EN initiation	Start with a small amount and gradually increase
Flow rate of EN infusion	Switch intermittent infusion to continuous infusion
Route of EN feeding	Switch jejunal feeding to gastric feeding
Use of drugs	1. Detailed adjustment of agents that improve gastrointestinal peristalsis or laxative 2. Administration of herbal medicine or antidiarrheal drugs (after ruling out the other causes of diarrhea)
Changing the type of EN formula	1. Contains dietary fibers 2. Hypoosmotic 3. Does not contain fat, lactose, or milk protein 4. Contains peptide as nitrogen source (oligomeric diet)
Semisolidification of EN formula	1. Change to an EN formula (Hine E-Gel®) that can semisolidify in the stomach 2. Change to viscosity-adjusted liquid food (Meiflow®, etc.) 3. Add a thickener (REF-P1®) to make it semisolid in the gastrointestinal tract 4. Change to a semisolid type EN formula (patient with gastrostomy).