The Incidence of Diarrhea in Patients with hypoalbuminemia Due to Acute or Chronic Malnutrition during Enteral Feeding

Objectives: Critically ill patients usually have hypoalbuminemia. The incidence of diarrhea in patients with hypoalbuminemia receiving enteral nutrition was studied. Methods: One hundred and ninety‐eight patients with serum albumin level below 3 g/dl in the Burn Unit and Nutritional Support Service were retrospectively studied. Diarrhea was defined as liquid or loose stool at least three times a day with a daily volume of more than 300 g for at least 2 days. Most patients in the Burn Unit had acute or subacute onset of hypoalbuminemia, and most patients who were referred to the Nutritional Support Service had a chronic onset of hypoalbuminemia. The patients whose diarrhea were due to formula‐related factors, administration techniques, or concomitant drug therapy were excluded. Results: The results showed that 27% of the patients with albumin levels less than 2 g/dl had diarrhea, but only 10.5% of patients with albumin levels higher than 2 g/dl had diarrhea; the difference was significant. Diarrhea occurred in 35.1% of the patients with chronic development of hypoalbuminemia, but only 9.9% of the patients with rapid development of hypoalbuminemia had diarrhea; that difference also was significant. Conclusions: We concluded that the hypoalbuminemia‐related diarrhea during tuhe feeding was significantly higher in patients with albumin levels less than 2 g/dl, and the patients with hypoalbuminemia due to chronic malnutrition had a significantly higher incidence of diarrhea than those with acute malnutrition, such as hurned patients.