Scoping review compares gastrointestinal tolerance and outcomes of feeding types in stroke patients, suggesting continuous feeding may reduce diarrhea.
Background and aims To map and synthesise current evidence comparing continuous and intermittent nasogastric enteral feeding in adult stroke patients with dysphagia, focusing on gastrointestinal tolerance, respiratory complications, nutritional outcomes, and safety. Methods A scoping review was conducted following the Arksey and O’Malley framework and reported in accordance with PRISMA guidelines. A systematic literature search was undertaken on 22 May 2025 across NHS Knowledge and Library Hub, MEDLINE, Embase, Emcare, HMIC, CINAHL, and Web of Science. Peer-reviewed randomised controlled trials involving adult stroke patients receiving intermittent or continuous nasogastric feeding were eligible. Data extraction and narrative synthesis were performed independently by two reviewers. Results Three randomised controlled trials involving 193 stroke patients met the inclusion criteria. Across studies, continuous feeding was consistently associated with a significantly lower incidence of diarrhoea compared with intermittent feeding. No statistically significant differences were observed between feeding regimens for aspiration pneumonia, vomiting, gastric retention, caloric intake, length of hospital stay, or mortality. Evidence relating to abdominal distension and glycaemic control was limited and inconsistent. Methodological heterogeneity and small sample sizes limited comparability. Conclusions Current evidence suggests that continuous nasogastric feeding may improve gastrointestinal tolerance in stroke patients with dysphagia, particularly in reducing diarrhoea. However, there is insufficient evidence to demonstrate superiority over intermittent feeding for respiratory, nutritional, or clinical outcomes. High-quality, stroke-specific trials are needed to inform nursing practice and guideline development. Conflict of interest Holly Maguire nothing to disclose Surabhi Saxena nothing to disclose
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