Which of the following is a common cause of nausea and vomiting in enterally fed patients?

• A. Too Rapid of a Rate of Bolus Infusion
• B. Gastric Outlet Obstruction Caused by Feeding Tube Migration
• C. Excessive Feeding Volume
• D. Gastroparesis

Answer: (A)

Nausea and vomiting in enteral feeding most often come from delivering the feed too quickly as a bolus. When a large volume is given in a short time, the stomach distends rapidly. That sudden stretch triggers protective reflexes via the vagus and vomiting center, producing nausea and emesis. Slowing the rate or switching to continuous feeding lets the stomach accommodate the volume more gradually, reducing the likelihood of this response. Other potential causes exist—such as tube migration causing obstruction, too much total volume at once, or impaired gastric emptying like gastroparesis—but they’re not as common as rapid bolus delivery. Thus, adjusting the rate of bolus feeding is the most effective first step to prevent or treat this symptom.