Which of the following is NOT among the six possible causes of constipation with enteral nutrition?

• A. Lack of adequate hydration
• B. Long term fiber-free feedings
• C. Prolonged bedrest
• D. Adequate hydration

Answer: (D)

Constipation in patients on enteral nutrition is influenced by factors that affect stool water content, stool bulk, and gut motility. Adequate hydration helps keep stools softer and promotes regular transit, so it does not contribute to constipation; it actually protects against it. The other options describe factors that can worsen constipation: not enough fluids dries out stools and slows their passage, long-term use of fiber-free formulas reduces stool bulk, and prolonged bedrest decreases gastrointestinal motility. So, the hydrated state is the one that is not a cause, acting as a protective factor rather than a risk.