Stool formation re: gastroenteritis

[opossum]

I recently had a pt w/ gastroenteritis related to eating bitter squash (fascinating topic for another thread) and we started talking about her stools, which have been loose and a dark orange-y, iodine-like color from its onset. I mentioned how her stools will eventually become more solid, to which she replied "but they won't get solid until I eat solid food. I'm still on liquids." (Paraphrasing here).

Was I wrong in telling her that she can expect her stools to become more solid as the gastroenteritis resolves? I feel like I may be asking a dumb question here, but when a pt is on a clear liquid or full liquid diet, can they form semi-solid stool?

[wooh, BSN, RN]

It will be less frequent and watery, but it's not going to form up much until there's some fiber in whatever they're eating. (At least that's my understanding and experience with digestive systems. Maybe a more GI focused nurse will come along and correct me!)

[TiffyRN, BSN, PhD]

My area of experience is mostly neonatal. Infants regularly have semi-formed or mushy stools on an all liquid diet. It's more about intestinal motility and state of hydration as well as nutrient content. When an infant is fed a high calorie infant formula is is not unusual for them to have formed stools every 1-2 days.

Fiber definitely affects the bulkiness of stool, but protein can have a huge effect. When I worked with adult patients I saw patients on high protein, high calorie tube feeding formulas (such as Nepro) consistently have solid, hard stools. They also had the disadvantage of being kept "dry" as most patients on Nepro are renal dialysis patients.

Also fiber does not always equal formed stools. Some patients with irritable bowel type conditions are advised to avoid fiber as this will speed their already overactive intestines and cause more frequent loose stools and cramping.

So the answer is that your patient can form semi-solid stools on an all liquid diet. How solid the stool is will be determined by a combination of intestinal motility, fiber and protein content, as well as hydration status.

[opossum]

Thanks for your replies!