A retrospective chart review to assess feeding tolerance in adults who had been switched from an intact protein formula to a peptide-based formula due to feeding intolerance in a complex continuing care facility.

Inclusion Criteria:

• > 18 years of age on admission to facility
• Prescribed enteral nutrition with the goal to provide at least 90% of estimated daily calorie and protein requirements for ≥ 2 weeks prior to switch
• Received enteral nutrition with an intact protein formula for a minimum of three days prior to a switch to a peptide-based formula
• Have documentation of intolerance to an intact protein formula, followed by a switch in formula received to a peptide-based formula
• Receiving a peptide-based formula formula for ≥ 2 weeks
• Have documentation of an assessment of feeding tolerance following the switch
• Formulas received must be indicated for use in adults.

Exclusion Criteria:

• Abdominal surgery (within past 30 days prior to switch)
• Having any infection, including upper respiratory, viral, gastroenteritis,wound infections, c difficile, at time of switch
• Having documented cow's milk protein allergy at time of switch
• Medical records lacking information on rationale for switch to a peptide-based formula and/or response to change (positive, neutral or negative).

The population studied retrospectively will be adult patients in a chronic care facility dependent on enteral nutrition for 90% or more of their nutritional needs and meeting the inclusion/ exclusion criteria.