Enteral intact protein formulations may coagulate with contact with which condition?

• A. Acidic pH
• B. Neutral pH
• C. Alkaline pH
• D. High temperature

Answer: (A)

Coagulation of intact protein formulations occurs when they encounter a highly acidic environment, such as the stomach. The very low pH destabilizes the protein structure and promotes aggregation and precipitation, especially with proteins like casein that form curds in acid. This results in a gel or clot-like mass that increases viscosity and can slow gastric emptying or clog enteral tubes. Neutral or alkaline conditions keep proteins more soluble, so they’re less likely to coagulate, and while high temperature can denature proteins, the described coagulation in this context is driven by contact with acidic pH.