Gastrointestinal Tolerance to Maranta arundinacea (Arrowroot) Powder Added to Formula Feeds in Intensive Care Unit Patients: A Nonrandomized Controlled Quasi-experimental Trial

Background and aims: Diarrhea is common in critically ill patients receiving enteral nutrition and often leads to feed interruption.Arrowroot (Maranta arundinacea) is rich in soluble fiber, and may improve gastrointestinal (GI) tolerance.This study evaluated the safety and GI tolerance of adding arrowroot powder to enteral formula (EF) feeds. Patients and methods:A nonrandomized controlled open labeled, quasi-experimental, posttest-only trial was conducted in intensive care unit (ICU) patients receiving nasogastric enteral feeding.The intervention group received 100 gm of arrowroot powder added to formula feeds for 5 days; controls received standard formula feeds.Gastrointestinal intolerance to the specified weight of arrowroot powder was observed as incidence of new-onset noninfectious diarrhea, vomiting, and abdominal distension.Clinical outcomes included hospital-acquired infections, ICU/hospital length of stay (LOS) and ICU mortality.Results: Ninety-four patients were included (34 intervention, 60 control).Arrowroot supplementation was well tolerated, with no adverse GI effects.New-onset diarrhea was lower in the intervention group (8.8 vs 26.7%), though not statistically significant.Relative risk reduction was 0.67.No differences in nosocomial infections, mortality, or LOS were observed.Conclusion: Arrowroot supplementation in enteral feeds appears feasible and, safe in critically ill patients.Its potential as a supplement to enteral feeds to reduce diarrhea needs to be explored with larger studies.