Which sign indicates intolerance to enteral feeding?

• A. Absence of distention
• B. Gas, distention, residuals, vomiting indicate intolerance
• C. Pain alone
• D. Weight gain

Answer: (B)

Intolerance to enteral feeding is suggested by signs of poor GI tolerance, particularly gas production with abdominal distention, large gastric residuals, and vomiting. Gas and distention indicate the bowel isn’t handling the feeds well, often from slowed motility or evolving intolerance. Large residuals show the stomach isn’t emptying properly, increasing the risk of regurgitation and aspiration. Vomiting directly signals the feeds aren’t being tolerated. By contrast, absence of distention isn’t supportive of intolerance, pain alone is non-specific, and weight gain doesn’t indicate intolerance and could reflect adequate nutrition or fluid shifts.