A patient, with an inability to swallow following a stroke, is receiving full-strength formula through a nasogastric feeding tube and is experiencing diarrhea. Which is the most likely cause of the diarrhea?
A) Osmotic causes
B) Secretory causes
C) Inflammatory bowel
D) Motility causes
A) Osmotic causes
Explanation: A) In osmotic causes of diarrhea, nonabsorbable substances in the lumen of the bowel draw water into the bowel (e.g., ingestion of synthetic sugars, such as sorbitol or full-strength tube feeding formulas).
B) In secretory causes, excessive mucosal secretion interferes with chloride and sodium transport, decreasing water absorption (e.g., bacterial and viral infections).
C) In inflammatory bowel causes, inflammation causes smooth muscle contraction, cramping, urgency, and frequency of elimination (e.g., ulcerative colitis, Crohn disease).
D) In motility causes, excessive motility decreases mucosal surface contact time, decreasing opportunity for absorption (e.g., short bowel syndrome, laxative abuse).
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