Which of the following is a potential cause of abdominal distention due to enteral feeding?

• A. Fat, fiber or lactose intolerance
• B. Infection
• C. Cold formula
• D. Rapid administration

Answer: (A)

Abdominal distention from enteral feeding is most often due to intolerance to components of the formula, which leads to gas production and increased luminal volume. When lactose isn’t well absorbed because of lactase deficiency, undigested lactose passes into the colon and is fermented by bacteria, producing gas and drawing water into the bowel—this causes bloating and distention. Fat or fermentable fiber in the formula can likewise be poorly tolerated by some patients, leading to slowed transit, gas, and further distension as the gut ferments these components. These intolerance mechanisms directly explain why distention occurs with enteral feeds.

Infection can cause distention too, but it usually comes with additional signs like fever or systemic symptoms and isn’t as directly tied to the feeding components. Cold formula and rapid administration don’t explain the typical distention pattern as clearly as component intolerance.