Which of the following is a listed reason constipation can occur with enteral nutrition?

• A. High-protein diet
• B. Regular physical activity
• C. Narcotics
• D. Adequate hydration

Answer: (C)

Opioid medications slow gut movement by acting on mu receptors in the gastrointestinal tract. This reduces peristaltic contractions, increases anal sphincter tone, and decreases GI secretions, all of which slow transit and lead to harder stools. In someone on enteral nutrition, this slowing effect combines with often limited fiber intake and fluid intake, making constipation more likely. That’s why narcotics are a listed reason for constipation with enteral feeding. Generally, high-protein diets, regular physical activity, and adequate hydration support bowel movements, so they aren’t typical contributors to constipation in this setting.