Factors associated with gastrointestinal intolerance to enteral feeding in patients with traumatic brain injury

Objective: To determine frequency of gastrointestinal intolerance to enteral feeding in patients with traumatic brain injury (TBI) and identify independent predictors of gastrointestinal intolerance among traumatic brain injury patients Methodology: This prospective observational cohort study was conducted at the Department of Neurosurgery, Unit-I, Punjab Institute of Neurosciences, Lahore, Pakistan, involving TBI patients on enteral nutrition from March 2026 to May 2026. Data was analyzed using Statistical Package for social sciences (SPSS), version 29. After descriptive analysis, Chi-square was used to identify factors associated with gastrointestinal intolerance and binary logistic regression was applied to identify independent predictors of gastrointestinal intolerance to enteral feeding. Results: Of the total 50 patients included in this study, there were 40% (20) males with the mean age of 37.9±16.1 years. Enteral nutrition was well-tolerated in 10% (5) patients, while 90% (45) suffered from GI intolerance to enteral nutrition. Of these 45 patients, intolerance was settled after temporary cessation of feeding, 57.7% (26), 48.8% (22) patients settled after receiving gastroprokinetics, 11.1% (5) settled by changing feeding formula, and 11.1% (5) underwent adjustment of feeding rates. Patients with mild and moderate TBI had significantly lower odds of developing GI intolerance when compared with patients with severe TBI i.e., OR: 0.025 (95% CI: 0.002-0.277), p=0.003 and OR: 0.080 (95%CI: 0.007-0.888), p=0.040 respectively after adjustment for diabetes and use of gastroprokinetic drugs. Conclusion: The occurrence of moderate to severe gastrointestinal intolerance was more frequent in moderate to severe TBI. Severity of TBI is independent predictor of moderate-to-severe gastrointestinal intolerance in TBI patients.