A patient who had an ileal resection experiences diarrhea during tube feeding. What could be the cause?

When a patient experiences diarrhea during tube feeding following an ileal resection, one possible cause is the use of a hypertonic formula. Following an ileal resection, the patient's ability to absorb fluids and electrolytes may be compromised, and the ileum plays a significant role in nutrient absorption. Hypertonic formulas can lead to an osmotic imbalance in the gut, resulting in diarrhea as the intestines attempt to dilute the excess solute concentration.

In contrast, isotonic formulas are designed to closely match the osmolarity of blood, which typically helps to minimize gastrointestinal distress in patients. Inadequate fluid intake could lead to dehydration or other complications, but it is less likely to be the direct cause of diarrhea compared to the osmotic effects of a hypertonic formula. While excessive protein in the diet can sometimes lead to gastrointestinal discomfort, it is typically not as directly associated with diarrhea in the context of a hypertonic feeding formula. Thus, the specific mechanism by which hypertonic formulas can cause increased water secretion in the intestines makes this option the most plausible cause of the patient's diarrhea.