What is it called when you're fed through a tube?: Enteral Nutrition Explained

According to the American College of Gastroenterology, enteral nutrition is any method of feeding that uses the gastrointestinal (GI) tract to deliver nutrients and calories. This process, commonly known as tube feeding, is a critical medical intervention for individuals who cannot safely consume enough food and liquids orally to meet their nutritional needs.

Quick Summary

This article explains that being fed through a tube is called enteral nutrition, detailing the types of tubes used and the reasons for their necessity. It also covers the contrast with parenteral nutrition, the risks involved, and essential care instructions for those using a feeding tube.

Key Points

• Term: Being fed through a tube is medically called enteral nutrition, which involves delivering nutrients to the GI tract via a tube.

• Types: Feeding tubes are classified as short-term (e.g., Nasogastric or NG tube) or long-term (e.g., Gastrostomy or G-tube), depending on the required duration of nutritional support.

• Difference from IV Feeding: Unlike parenteral nutrition (IV feeding), enteral nutrition requires a functional gastrointestinal system.

• Common Conditions: Conditions like strokes, head and neck cancers, and neurological disorders that affect swallowing often necessitate tube feeding.

• Proper Care: Caregivers must regularly clean the insertion site, flush the tube to prevent blockages, and elevate the patient's head during feedings to avoid complications.

• Potential Risks: Common risks include aspiration pneumonia, infection at the tube site, and gastrointestinal issues like diarrhea or constipation.

Understanding Enteral Nutrition

Enteral nutrition is the medical term for delivering liquid nutrients directly into the gastrointestinal (GI) tract via a feeding tube. This is used for patients whose GI tract is still functional but who are unable to eat by mouth due to an illness, injury, or other medical condition. For example, a patient recovering from a stroke that has impaired their ability to swallow (dysphagia) may require enteral nutrition to maintain proper hydration and nutritional levels. The specific type of feeding tube used depends on the patient's condition, the anticipated duration of treatment, and the location where the nutrients need to be delivered.

Short-Term vs. Long-Term Tube Feeding

The duration a patient needs tube feeding heavily influences the type of tube placed. Short-term tubes are typically less invasive and are often used for a few weeks. For longer-term needs, a more durable and comfortable tube is usually required.

Short-Term Tubes (up to 4-6 weeks)

• Nasogastric (NG) Tube: A flexible tube inserted through the nose, down the esophagus, and into the stomach. It is a common choice for patients who need temporary nutritional support, such as after surgery or for those with short-term swallowing issues.
• Nasojejunal (NJ) Tube: Similar to an NG tube, but it extends past the stomach into the small intestine (jejunum). This is an option for patients who cannot tolerate feedings in the stomach.

Long-Term Tubes (over 4-6 weeks)

• Gastrostomy (G-tube) or Percutaneous Endoscopic Gastrostomy (PEG) Tube: A tube surgically placed directly into the stomach through a small incision in the abdomen. This is a common choice for long-term feeding because it is more discreet and comfortable.
• Jejunostomy (J-tube): A tube surgically placed through the skin of the abdomen into the jejunum. It is used when the stomach must be bypassed, for example, due to motility issues or surgical complications.

The Importance of Enteral Nutrition

Enteral nutrition serves several vital functions in patient care. The most significant is preventing malnutrition and dehydration, which can severely hinder recovery. It ensures that patients, who might otherwise have trouble eating, still receive the necessary calories, proteins, vitamins, and minerals. By delivering nutrients directly to the gut, it helps maintain the function of the gastrointestinal system, which is critical for immune health. Additionally, it allows for the safe administration of medications that a patient might not be able to swallow.

Enteral Nutrition vs. Parenteral Nutrition

Understanding the distinction between enteral and parenteral nutrition is crucial. While both are forms of nutritional support, their methods of delivery are fundamentally different.

Feature	Enteral Nutrition	Parenteral Nutrition (TPN)
Delivery Method	Liquid formula delivered directly into the gastrointestinal (GI) tract via a tube.	Liquid nutrition delivered directly into the bloodstream intravenously (IV).
GI Tract Usage	Requires a functional GI tract.	Bypasses the GI tract entirely.
Primary Use Case	Patients who can't chew or swallow safely but have a working digestive system.	Patients with a non-functional GI tract, severe malabsorption issues, or who need complete bowel rest.
Risk of Complications	Generally considered lower risk; complications include aspiration, infection at the site, and tube blockages.	Higher risk of serious complications like bloodstream infections, metabolic issues, and liver complications due to the direct access to the blood.
Nutrient Delivery	More closely mimics natural digestion and absorption.	Requires a carefully formulated intravenous solution to provide all necessary nutrients.

Potential Risks and Complications

While tube feeding is a life-sustaining intervention, it is not without potential risks. Some common complications include:

• Aspiration Pneumonia: This occurs if the formula enters the lungs, a risk that can be reduced by keeping the patient's head elevated during and after feedings.
• Infection: The tube insertion site, particularly with G-tubes or J-tubes, can become infected if not properly cleaned and cared for.
• Gastrointestinal Issues: Diarrhea, constipation, bloating, and cramping are common side effects, often managed by adjusting the feeding schedule or formula.
• Tube Blockage or Displacement: The feeding tube can become clogged or dislodged, requiring attention from a healthcare provider.
• Refeeding Syndrome: In severely malnourished patients, rapid reintroduction of nutrition can cause dangerous electrolyte shifts, which require careful monitoring.

Living with and Caring for a Feeding Tube

For patients and their caregivers, proper tube feeding management is key to preventing complications and maintaining quality of life. A healthcare provider will offer detailed instructions, but some general guidelines include:

• Site Care: Clean the skin around the tube insertion site with mild soap and water daily to prevent infection.
• Flushing: Flush the tube with water before and after each feeding and medication administration to prevent blockages.
• Positioning: Keep the patient's head elevated during feedings to reduce the risk of aspiration.
• Medication Administration: Administer medications one at a time, flushing the tube between each dose. Liquid medication is preferred.
• Monitor for Problems: Be vigilant for signs of infection (redness, swelling, pain) or tube complications (clogging, leakage) and report them to a doctor.

Conclusion

In conclusion, when you're fed through a tube, the process is medically termed enteral nutrition. This intervention is crucial for individuals who cannot meet their nutritional needs orally but have a functional digestive system. While there are different types of tubes and delivery methods tailored to specific patient needs, proper care and monitoring are essential to prevent complications. Enteral nutrition provides a lifeline, ensuring patients receive the vital sustenance required for healing and recovery, ultimately supporting their overall well-being. For those with a non-functional GI tract, the alternative is parenteral nutrition, which delivers nutrients directly into the bloodstream. Navigating these options with a medical team ensures the most effective and safe nutritional path forward.

Frequently Asked Questions

What are the common types of tubes used for enteral nutrition?

Common types include nasogastric (NG) tubes, which are temporary and go through the nose to the stomach, and gastrostomy (G-tube) or PEG tubes, which are surgically placed directly into the stomach for longer-term use.

Can a person still eat and drink normally with a feeding tube?

It depends on the medical condition. Some patients may be able to eat and drink small amounts while also using a feeding tube for supplemental nutrition, while others may receive all their nutrients through the tube.

What is the main difference between enteral and parenteral nutrition?

Enteral nutrition delivers food directly to the digestive system via a tube, whereas parenteral nutrition bypasses the digestive system entirely and delivers nutrients directly into the bloodstream through an IV.

How is a feeding tube inserted?

Insertion methods vary. Short-term tubes like NG tubes are placed non-surgically through the nose. Long-term tubes like G-tubes are surgically inserted through a small incision in the abdomen, often with the guidance of an endoscope or X-ray.

Is getting a feeding tube painful?

While temporary tubes like NG tubes can cause some nasal and throat irritation, and surgical insertion of long-term tubes may cause initial soreness, the process is generally manageable. Pain medication is used to control discomfort, which typically subsides after a few days.

What are the potential complications of tube feeding?

Complications can include aspiration pneumonia (formula entering the lungs), infection at the insertion site, gastrointestinal issues like diarrhea, or tube-related problems such as clogging or displacement.

How do you care for a feeding tube at home?

Key care steps include cleaning the tube site daily with soap and water, flushing the tube regularly with water before and after use, and monitoring for signs of infection or leakage. A healthcare provider will provide specific instructions.