Which fiber sources can be used to manage diarrhea by adding to enteral formula?

• A. Banana flakes or psyllium
• B. Honey or syrup
• C. Rice water or corn starch
• D. Gluten

Answer: (A)

Managing diarrhea with enteral feeds hinges on adding soluble fiber that forms a gel and increases stool bulk, which helps absorb excess water and slow intestinal transit. Banana flakes and psyllium provide this type of fiber. Psyllium husk is a well-known soluble fiber that swells in liquid to create a viscous stool, reducing liquidity and frequency when added to formula. Banana flakes contribute pectin-rich soluble fiber, which also gels and helps firm the stool while contributing some nutrients. Together, they modulate stool consistency without drastically changing osmolar load.

The other options don’t provide the same stool-forming, water-absorbing effect. Honey or syrup are simple sugars that can raise osmotic load and worsen diarrhea. Rice water or corn starch add carbohydrates but not meaningful soluble fiber and can increase osmolality, potentially worsening symptoms. Gluten is a protein, not a fiber, and has no role in improving stool form or diarrhea management in enteral nutrition.