Enteral feeding

Enteral Feeding

Enteral feeding, also known as tube feeding, is a method of delivering nutrition directly to the stomach or small intestine. This technique is used for patients who are unable to consume food orally but have a functioning gastrointestinal tract. Enteral feeding is a critical component of medical care for patients with various conditions, including neurological disorders, head and neck cancers, and severe anorexia.

Indications

Enteral feeding is indicated in patients who cannot meet their nutritional needs through oral intake alone. Common indications include:

• Dysphagia due to neurological conditions such as stroke or Parkinson's disease.
• Severe anorexia nervosa.
• Head and neck cancers that obstruct the oral or esophageal passage.
• Critical illness where oral intake is insufficient.
• Chronic conditions such as cystic fibrosis or Crohn's disease.

Types of Enteral Feeding Tubes

There are several types of enteral feeding tubes, each suited for different clinical situations:

• Nasogastric Tube (NGT): Inserted through the nose into the stomach. Used for short-term feeding (less than 4-6 weeks).
• Nasointestinal Tube: Similar to NGT but extends into the small intestine. Used when gastric feeding is not tolerated.
• Gastrostomy Tube (G-tube): Surgically placed directly into the stomach through the abdominal wall. Suitable for long-term feeding.
• Jejunostomy Tube (J-tube): Placed into the jejunum, often used when gastric feeding is contraindicated.

Administration Methods

Enteral feeding can be administered using different methods depending on the patient's needs:

• Bolus Feeding: Nutritional formula is given in large amounts at set intervals, similar to normal meal times.
• Continuous Feeding: Formula is delivered slowly over 24 hours using a pump, often used in critically ill patients.
• Intermittent Feeding: Similar to bolus but given over a longer period, allowing for breaks in between.

Complications

While enteral feeding is generally safe, it can be associated with complications:

• Mechanical Complications: Tube dislodgement, blockage, or kinking.
• Gastrointestinal Complications: Nausea, vomiting, diarrhea, or constipation.
• Metabolic Complications: Electrolyte imbalances, dehydration, or overhydration.
• Infectious Complications: Infection at the insertion site, especially with gastrostomy or jejunostomy tubes.

Monitoring and Management

Patients receiving enteral feeding require careful monitoring to ensure adequate nutrition and prevent complications:

• Regular assessment of nutritional status and adjustment of feeding regimen as needed.
• Monitoring for signs of intolerance such as abdominal distension or diarrhea.
• Ensuring proper tube care and hygiene to prevent infections.

Conclusion

Enteral feeding is a vital intervention for patients unable to meet their nutritional needs orally. It requires a multidisciplinary approach involving physicians, nurses, dietitians, and caregivers to ensure optimal outcomes and minimize complications.

See Also

• Parenteral nutrition
• Nutritional support
• Gastroenterology

References

• Smith, J. (2020). Enteral Nutrition: A Comprehensive Guide. New York: Medical Publishing.
• Jones, A., & Brown, L. (2019). Clinical Nutrition in Practice. London: Health Press.