What is enteral feeding?
Enteral feeding is the delivery of nutrients, fluids, and medication directly into the gastrointestinal (GI) tract through a flexible tube. The most common and direct answer to what is another word for enteral feeding? is tube feeding. While these terms are often used interchangeably, "enteral nutrition" is a broader term encompassing any form of nutritional support that uses the gut, including oral nutrition supplements, though it's most frequently associated with tube feeding. The digestive system remains active, allowing for the absorption of nutrients, which is considered a more natural and cost-effective method than bypassing the gut entirely through intravenous (parenteral) nutrition.
Who needs enteral feeding?
Patients who cannot safely swallow or consume enough nutrition by mouth but have a functioning GI tract are candidates for enteral feeding. The reasons for this can be short-term or long-term and include:
- Neurological disorders: Conditions such as stroke, Parkinson's disease, or multiple sclerosis can impair a patient's ability to swallow (dysphagia).
- Head and neck cancers: Tumors or the effects of radiation and chemotherapy can make eating difficult and painful.
- Gastrointestinal issues: Problems like upper GI obstruction or severe Crohn's disease can necessitate bypassing parts of the digestive system.
- Critical illness or injury: Trauma, burns, or being on a ventilator can make eating orally impossible or insufficient.
- Failure to thrive: Pediatric patients who are unable to meet their nutritional needs can be supported with enteral feeding.
Types of enteral feeding tubes
Feeding tubes are categorized based on their entry point and final destination. The choice depends on the anticipated duration of feeding and the patient's medical condition.
- 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: A tube passed through the nose, stomach, and into the jejunum (part of the small intestine). Used when the stomach needs to be bypassed.
- Gastrostomy (G-tube): A tube inserted directly into the stomach through a small incision in the abdomen. This is a more permanent solution for long-term use. A specific type is a Percutaneous Endoscopic Gastrostomy (PEG) tube.
- Jejunostomy (J-tube): A tube inserted directly into the jejunum through the abdominal wall, bypassing the stomach completely. It's often used for patients with impaired stomach emptying or high aspiration risk.
- Gastro-jejunostomy (GJ-tube): This combination tube has a port ending in the stomach for drainage and a port extending into the jejunum for feeding.
Delivery methods for enteral feeds
Enteral feeding can be administered in several ways, often determined by the patient's tolerance and feeding site.
- Bolus Feeding: Delivered as large, discrete amounts of formula several times a day, mimicking mealtimes. This is primarily for stomach-feeding and allows for more freedom between feedings.
- Continuous Feeding: A steady, slow drip of formula is administered over 8 to 24 hours, usually with a pump. This is necessary for feeding directly into the small intestine, which cannot handle large volumes at once.
- Cyclic Feeding: A type of continuous feeding delivered over a shorter period, often at night, to allow for daytime mobility.
Comparing common enteral feeding tubes
| Feature | Nasogastric (NG) Tube | Gastrostomy (G-tube / PEG) | Jejunostomy (J-tube / PEJ) |
|---|---|---|---|
| Anticipated Duration | Short-term (typically 4-6 weeks) | Long-term (more than 4-6 weeks) | Long-term |
| Tube Placement | Through the nose and esophagus into the stomach | Surgically or endoscopically through the abdominal wall into the stomach | Surgically or radiologically through the abdominal wall into the jejunum |
| Key Advantage | Non-surgical placement, can be placed at bedside | More cosmetically acceptable and less prone to dislodgement than NG tubes | Reduced risk of aspiration, especially for patients with gastric motility issues |
| Primary Disadvantage | Easily dislodged, can cause nasal/throat discomfort, higher aspiration risk | Potential for skin irritation, infection, or leakage at the site | Requires surgical or radiological procedure for placement, continuous infusion often necessary |
Best practices for caring for a feeding tube
Proper care is crucial to prevent complications and ensure safe, effective feeding. Key responsibilities include:
- Flush the tube: Always flush the tube with water before and after feedings or medication administration to prevent clogging. This should be done even on non-feeding days to keep the tube clear.
- Elevate the head: Keep the head of the bed elevated to at least 30-45 degrees during feeding and for a period afterward, especially for gastric feeds, to reduce the risk of aspiration.
- Maintain hygiene: Clean the insertion site daily with soap and water to prevent infection. Monitor for signs of infection such as redness, swelling, or pus.
- Verify tube placement: Mark the tube where it enters the nose or stoma and check this mark regularly to ensure it hasn't moved. The best confirmation is by x-ray after initial placement.
- Medication administration: Consult with a pharmacist regarding proper medication preparation for tube delivery. Never crush extended-release or enteric-coated drugs.
- Manage complications: Be aware of potential issues like nausea, vomiting, or diarrhea and report them to a healthcare provider. Never use carbonated beverages to clear a clog.
Conclusion
In summary, while “tube feeding” is a common and easy-to-understand alternative for what is another word for enteral feeding?, the proper medical term is enteral nutrition. This method of delivering nutrients directly to a functioning gastrointestinal tract is a vital form of medical nutrition therapy for patients who cannot meet their needs orally. By using different types of tubes and delivery methods, healthcare teams can provide safe, effective, and individualized nutritional support. Proper care and monitoring are essential to prevent complications and ensure the best possible patient outcomes. Enteral feeding is a testament to the advancements in medical science, providing a life-sustaining option that uses the body's own digestive processes for optimal health.
For more detailed information and guidelines on enteral nutrition, please consult authoritative medical resources like the National Institutes of Health.
