What is another name for the enteral?
The term "enteral" simply means of, relating to, or inside the intestines. In a medical and nutritional context, the most common alternative name for the enteral route of nutritional delivery is tube feeding. Another, more technical, synonym is enteric feeding. All these terms refer to the delivery of liquid nutrition directly into the gastrointestinal (GI) tract via a tube, bypassing the process of chewing and swallowing. This method is distinct from parenteral nutrition, which provides nutrients intravenously and bypasses the digestive system entirely.
Why is Enteral Nutrition Prescribed?
Enteral nutrition is a critical intervention for patients who cannot meet their nutritional needs through oral food intake alone but have a functional GI tract. This need can arise from various medical conditions, including:
- Neurological disorders: Conditions like stroke, Parkinson's disease, or amyotrophic lateral sclerosis (ALS) can impair the swallowing reflex (dysphagia), making eating by mouth unsafe.
- Critical illness: Patients on mechanical ventilation or those with severe head injuries often require enteral support to ensure adequate nutritional intake.
- Gastrointestinal issues: Certain GI disorders, such as pancreatitis, inflammatory bowel disease, or conditions causing malabsorption, may require tube feeding.
- Hypermetabolic states: Traumas, severe burns, or sepsis significantly increase the body's energy demands, which may be impossible to meet orally.
- Head and neck cancers: Tumors or surgery in the oropharyngeal area can create a physical obstruction, preventing normal eating.
Types of Enteral Feeding Tubes and Delivery Methods
The selection of a feeding tube depends on the expected duration of nutritional support and the patient's specific medical condition.
Types of feeding tubes:
- Nasogastric (NG) tube: A tube inserted through the nose, down the esophagus, and into the stomach. Used for short-term feeding, typically less than four to six weeks.
- Nasojejunal (NJ) tube: Similar to an NG tube, but the tube extends into the jejunum (small intestine). Often used for patients with gastric motility issues or high aspiration risk.
- Gastrostomy (G-tube): A tube surgically placed directly into the stomach through the abdominal wall. A more permanent solution for long-term feeding.
- Jejunostomy (J-tube): Surgically placed into the jejunum. Used for long-term feeding when gastric feeding is not tolerated.
- Gastrojejunostomy (GJ-tube): Combines a G-tube and J-tube, allowing for both gastric drainage and jejunal feeding.
Methods of delivery:
- Bolus feeding: Administering a specific volume of formula over a short period, typically several times a day, mimicking meal patterns. This is only suitable for gastric feeding.
- Continuous feeding: Delivering formula at a constant rate over 8 to 24 hours, often via a pump. Common for jejunal feeding.
- Intermittent feeding: Giving formula over a shorter time frame (e.g., 30-60 minutes) multiple times per day. Can be used to transition towards bolus feeding or promote appetite during the day.
Enteral vs. Parenteral Nutrition: A Comparison
| Feature | Enteral Nutrition | Parenteral Nutrition (PN) |
|---|---|---|
| Delivery Route | Directly into the gastrointestinal (GI) tract via a tube. | Directly into the bloodstream via an intravenous (IV) catheter. |
| GI Tract Involvement | Requires a functional GI tract for digestion and absorption. | Bypasses the GI tract entirely, used when the gut is non-functional. |
| Invasiveness | Less invasive; tube placed through the nose or a minor surgical procedure. | More invasive; requires a central or peripheral vein catheter. |
| Cost | Generally less expensive than parenteral nutrition. | More expensive due to specialized formula and sterile delivery. |
| Risk Profile | Lower risk of serious infection compared to parenteral feeding. | Higher risk of systemic infections, liver issues, and metabolic complications. |
| Nutrient Absorption | Relies on natural digestive processes to absorb nutrients. | Delivers pre-digested nutrients directly into the circulation. |
Advantages and Potential Complications of Enteral Nutrition
Advantages of enteral feeding:
- Preserves gut function: Feeding the GI tract maintains mucosal integrity, preventing atrophy and supporting the immune system.
- Lower risk of infection: By avoiding direct access to the bloodstream, enteral feeding carries a significantly lower risk of systemic infections compared to PN.
- Physiological benefits: It stimulates normal hormone responses and promotes intestinal health.
- Cost-effective: It is a more affordable and simpler method of nutritional support.
Potential complications of enteral feeding:
- Aspiration: Accidental inhalation of formula into the lungs, a potentially life-threatening complication, especially with nasogastric tubes and certain risk factors.
- Diarrhea or constipation: GI issues are common side effects and can often be managed with adjustments to formula type, rate, or hydration.
- Tube-related issues: This includes accidental dislodgment, tube blockages, and skin irritation or infection at the insertion site.
- Refeeding syndrome: A severe metabolic disturbance that can occur when severely malnourished patients are fed too aggressively. It can lead to dangerously low electrolyte levels.
Managing Enteral Nutrition at Home
For many patients, enteral nutrition is a long-term solution managed at home. Successful home management requires proper training for patients and caregivers on several key aspects:
- Feeding regimen: Understanding the specific type of feeding (e.g., bolus or continuous), the prescribed formula, and the delivery equipment.
- Tube and site care: Following strict hygiene protocols to clean and care for the feeding tube and the stoma site to prevent infection.
- Monitoring and troubleshooting: Learning to identify signs of intolerance (e.g., nausea, bloating) or potential tube complications and knowing when to contact a healthcare professional.
- Access to support: Patients are often part of a home enteral nutrition (HEN) service that provides ongoing support from dietitians and nurses, delivering supplies and handling out-of-hours issues.
Conclusion
In summary, the answer to what is another name for the enteral? is most practically understood as tube feeding or enteral feeding. This method provides vital nutritional support when oral intake is compromised but the digestive system remains functional. While it offers significant advantages over intravenous feeding, proper administration and diligent monitoring are crucial to prevent complications and ensure the best possible health outcomes. For patients requiring long-term support, managing enteral nutrition at home with the assistance of a dedicated healthcare team can provide independence and improved quality of life.
Visit a dedicated resource for more information on home enteral nutrition management.
