A patient receiving continuous isotonic enteral formula experiences bloating and mild abdominal distention. What is the best initial strategy?

• A. Hold enteral nutrition and administer a pain reliever
• B. Initiate a bowel regimen if constipation suspected
• C. Switch to a higher fiber formula
• D. Change to bolus feeding regimen

Answer: (B)

Constipation is a common and treatable cause of bloating and mild abdominal distention in patients on continuous enteral nutrition. Starting a bowel regimen addresses the likely reversible factor by promoting stool passage and reducing gas buildup, which can immediately improve tolerance to the feeding without interrupting nutrition. Holding feeds or switching formulas aren’t first-line for suspected constipation, and giving a pain reliever can mask symptoms. A bowel regimen (such as stool softener with a laxative or an osmotic laxative) is a direct, appropriate initial step to relieve distention and support ongoing nutrition.