What causes someone to need a feeding tube?: A Guide to Enteral Nutrition

October 16, 2025 •

4 min read

According to the National Institutes of Health, enteral nutrition, often referred to as a feeding tube, is used when a patient has a functioning gastrointestinal tract but cannot swallow food safely or consume enough nutrients by mouth. This intervention addresses critical nutritional needs for a wide array of medical conditions, ensuring adequate intake for healing and health.

Quick Summary

Numerous medical conditions can necessitate a feeding tube, including dysphagia, neurological disorders, severe malnutrition, cancer treatment, and critical illness, to ensure adequate nutrition.

Key Points

Swallowing Dysfunction: Dysphagia, or difficulty swallowing caused by conditions like stroke, Parkinson's disease, or head and neck cancer, is a primary reason for a feeding tube.
Neurological Impairment: Patients in a coma, with severe dementia, or on mechanical ventilation may require a feeding tube as they cannot safely or consciously eat.
Gastrointestinal Issues: Problems within the digestive tract, including bowel obstructions, severe Crohn's disease, or gastroparesis, can necessitate enteral nutrition to ensure proper absorption.
Severe Malnutrition: Individuals at risk of or already suffering from severe malnutrition due to chronic illness, critical injuries, or eating disorders may need a feeding tube to restore health.
Cancer Treatment: Surgery, chemotherapy, or radiation for head and neck cancers can make eating painful or impossible, requiring temporary or long-term tube feeding.
Congenital Issues: Premature infants or children born with developmental conditions affecting sucking and swallowing often need tube feeding to ensure adequate growth and nutrition.
Fluid and Medication Delivery: Besides nutrition, feeding tubes are often used to administer fluids and medications when a person cannot take them orally.

A feeding tube, or enteral nutrition, is a critical medical intervention used to deliver nutrients, fluids, and medication directly into the stomach or small intestine, bypassing the mouth and esophagus. This is not a decision taken lightly and is typically recommended by healthcare providers when a person cannot safely or sufficiently eat by mouth due to an underlying medical issue. The reasons for needing a feeding tube are diverse, spanning from temporary issues that impede swallowing to chronic conditions affecting nutrient absorption.

Dysphagia and Swallowing Problems

One of the most common reasons for needing a feeding tube is dysphagia, or difficulty swallowing. The act of swallowing is a complex process involving numerous muscles and nerves. When this process is impaired, it can lead to malnutrition, dehydration, and a serious risk of aspiration pneumonia, where food or liquid enters the lungs. Conditions that cause dysphagia include:

Neurological Disorders: A stroke is a primary cause of dysphagia, as it can damage the brain regions that control the muscles for swallowing. Other progressive neurological conditions like Parkinson's disease, multiple sclerosis, and amyotrophic lateral sclerosis (ALS) also frequently impair swallowing as the disease advances.
Head and Neck Cancer: Tumors or the side effects of cancer treatments, such as surgery or radiation therapy, can obstruct or damage the mouth, throat, or esophagus, making swallowing difficult or painful.
Structural Issues: Conditions that narrow the esophagus, such as strictures from acid reflux disease (GERD) or webs of tissue, can make it difficult for food to pass through.

Neurological and Consciousness-Related Issues

Beyond direct swallowing problems, certain neurological states and conditions that affect consciousness can prevent a person from eating voluntarily or safely. For example:

Coma or Reduced Alertness: Individuals who are unconscious or have greatly reduced alertness, such as after a severe head injury or trauma, require a feeding tube to receive nutrition.
Mechanical Ventilation: Patients on a breathing tube cannot safely eat or drink by mouth, making enteral feeding essential to meet their nutritional needs.
Severe Dementia: In advanced stages of dementia, a person may lose the ability to eat or swallow properly. Tube feeding is sometimes considered in end-of-life care discussions, though it requires a careful, personal decision.

Gastrointestinal and Digestive Tract Problems

Even if a person can swallow, a feeding tube might be necessary if the digestive tract is not functioning correctly or is unable to absorb nutrients. This can include:

Severe Crohn's Disease: For individuals with severe inflammatory bowel disease, the body may be unable to absorb adequate nutrients, leading to malnutrition.
Bowel Obstruction: A blockage in the bowel can prevent food from passing through, requiring a feeding tube to bypass the obstruction.
Gastroparesis: A condition where the stomach's muscles don't work properly, leading to delayed stomach emptying. A tube can be placed past the stomach (into the jejunum) to ensure nutrients are received.
Short Bowel Syndrome: After a significant portion of the small intestine is surgically removed, a feeding tube can supplement nutrition while the remaining bowel adapts.

Involuntary Malnutrition and Critical Illness

When malnutrition is severe and cannot be corrected by oral intake, or when the body's nutritional needs are extremely high, a feeding tube can provide life-saving support.

Burns and Critical Illness: Patients with severe burns or those in a critical state require a high number of calories and protein for healing, which may not be possible to consume orally.
Preterm Infants: Premature babies often lack the coordination to suck and swallow effectively, and a feeding tube is necessary to provide fortified breast milk or specialized formula.
Eating Disorders: Severe eating disorders can lead to dangerous levels of malnutrition that require aggressive nutritional intervention via tube feeding.

Comparison of Feeding Tube Types

Different types of feeding tubes are used depending on the expected duration of use and the patient's medical condition. The placement and tube type are crucial for effective enteral nutrition.


Feature	Nasogastric (NG) Tube	Gastrostomy (G-tube/PEG) Tube	Jejunostomy (J-tube) Tube
Placement	Through the nose, down the esophagus, into the stomach.	Through a small incision in the abdomen directly into the stomach.	Through an incision in the abdomen, into the small intestine (jejunum).
Duration	Short-term use (weeks to months).	Long-term use (months or years).	Long-term use.
Best For	Temporary swallowing issues, post-surgery recovery, or when long-term need is not anticipated.	Long-term nutritional support, especially for dysphagia, when the stomach functions normally.	When the stomach cannot tolerate or empty feeds, such as with severe reflux or gastroparesis.
Procedure	Bedside, non-surgical placement.	Endoscopic (PEG) or surgical placement.	Surgical placement.
Patient Comfort	Can cause nasal irritation and discomfort.	More comfortable and easier to conceal than NG tubes for long-term use.	May require continuous feeding and is used when the stomach is bypassed entirely.

Conclusion

Needing a feeding tube is a response to an underlying health challenge that compromises a person's ability to receive adequate nutrition through normal eating and swallowing. The reasons are varied and can be either temporary or long-term, from neurological damage and cancer treatment to congenital issues and severe GI disease. For many, enteral nutrition is a life-saving measure that allows the body to heal, maintains nutritional status, and prevents serious complications like aspiration pneumonia and severe malnutrition. Decisions about tube feeding are made in close consultation with a healthcare team, considering the specific medical condition, patient goals, and quality of life. Understanding the various causes helps destigmatize this essential medical intervention and focuses on the underlying issue it addresses.

For more information on dysphagia and swallowing disorders, the National Foundation of Swallowing Disorders is an excellent resource: Feeding Tubes and Dysphagia: What You Should Know.

Frequently Asked Questions

It depends on the individual's condition. For some, oral intake might be safe in small amounts or specific consistencies, while for others, the feeding tube provides all necessary nutrition. A doctor or speech-language pathologist will determine what is safe.

Not always. A feeding tube can be a temporary solution while a person recovers from an illness, injury, or treatment. It can be removed once oral intake becomes safe and adequate. However, for chronic conditions, a feeding tube may be needed long-term.

An NG tube is a temporary, non-surgical tube inserted through the nose into the stomach. A G-tube is a more permanent tube inserted surgically through the abdominal wall directly into the stomach, often preferred for long-term use.

While the insertion of a feeding tube may cause initial discomfort, especially with nasogastric tubes, it is not typically painful long-term. Healthcare providers ensure the patient's comfort and manage any site-related soreness for surgically placed tubes.

Potential risks include tube displacement, clogging, or infection at the insertion site. Side effects can include gastrointestinal issues like diarrhea or nausea, which can often be managed by adjusting the feeding plan.

Tube feeding can be a change, and some people may miss the social aspect of eating. However, it can also relieve the stress and struggle associated with mealtimes for those with severe swallowing difficulties, improving overall quality of life.

Doctors will conduct a comprehensive nutritional assessment and evaluate the patient's ability to swallow. Signs like significant weight loss, poor lab values, risk of aspiration, or difficulty consuming enough food are considered.