A Comprehensive Guide on Tube Feeding

January 5, 2023
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Feeding tubes are medical devices that are used to provide nutrition to individuals who are unable to eat or drink on their own.
There are several types of feeding tubes, including:

  • Nasogastric tubes (NG tubes), which are inserted through the nose and into the stomach. 
  • Orogastric tubes (OG tubes), which are inserted through the mouth and into the stomach.
  • Gastric tubes (G tubes) known as PEG tubes, are permanently placed in the stomach through a surgical procedure known as percutaneous endoscopic gastrostomy (PEG)
  • Jejunostomy tubes (J tubes), which are placed in the small intestine

Feeding tubes can be temporary or permanent, depending on the individual’s needs.

Temporary tubes are often inserted through the nose or mouth and can be removed when the person is able to eat and drink on their own again. Permanent tubes are usually placed through a surgical procedure and are used for long-term nutritional support.

What is Tube Feeding?

Feeding tubes are medical devices that are used to provide nutrition, fluids, and medications to individuals who are unable to eat or drink on their own. In addition to providing essential nutrients, feeding tubes can also be used to remove air from the stomach, reduce distention and bloating, and remove undigested food from the stomach to alleviate symptoms such as nausea, vomiting, and stomach pain.

It is usually necessary to insert tubes in the hospital, but they are also suitable for use in the home or in a nursing facility if you wish. Home enteral nutrition (HEN) is enteral nutrition provided at home, also known as tube feeding.

What Are the Reasons for Using Tube Feeding?

Feeding tubes can be an important tool for providing nutrition and hydration to individuals who are unable to eat or drink on their own. There are several reasons why a feeding tube may be necessary, including difficulty swallowing, an illness that makes it difficult to swallow, and the need for a ventilator.

When a person has difficulty swallowing, they may be at risk of choking or inhaling food and fluids into the lungs, which can lead to serious complications such as aspiration pneumonia.

Feeding tubes can help to prevent these risks by providing a safe and effective way to deliver nutrition and hydration directly to the stomach.

Additionally, when a person is too sick to swallow or requires a ventilator, a feeding tube can be an important way to ensure that they receive the nutrients and fluids they need to stay healthy. In some cases, a disease such as oral cancer may also make a feeding tube necessary.

What is the Procedure of Tube Feeding?

The procedure for tube feeding varies depending on the type of feeding tube being used. 

Nasogastric tubes and orogastric tubes are relatively straightforward to place, despite their discomfort. There is no need for anesthesia.

A nurse usually measures the tube’s length, lubricates the tip, inserts it into your nose or mouth, and advances it until it reaches your stomach. Usually, soft tape is used to attach the tube to your skin.

A syringe will be used to withdraw some gastric juice from the tube by a nurse or doctor. To confirm that the tube is in the stomach, they will check the pH (acidity) of the liquid.

The placement of the implant may be confirmed by a chest X-ray in some cases. It is possible to use the tube immediately after placement is confirmed.

The procedure for inserting a G tube or J tube is typically more complex and involves a surgical procedure. The surgeon will make a small incision in the abdomen and place the tube through the incision and into the stomach or small intestine. The tube is then secured in place with sutures or a special device.

Once the feeding tube is in place, nutrition, fluids, and/or medications can be delivered through the tube using a special pump or syringe. The frequency and amount of nutrients and fluids administered will depend on the individual’s specific needs and will be determined by a healthcare professional.

What are the Different types of Feeding Tubes?

There are several types of feeding tubes that can be used to deliver nutrition, fluids, and medications to individuals who are unable to eat or drink on their own. The type of feeding tube used will depend on the individual’s specific needs and the underlying cause of their inability to eat or drink.

Short-term feeding tubes, such as nasogastric tubes (NG tubes) and orogastric tubes (OG tubes), are inserted through the nose or mouth and into the stomach and are typically used for a period of four to six weeks. 

Long-term feeding tubes, such as gastric tubes (G tubes) and jejunostomy tubes (J tubes), are placed through a surgical incision in the abdomen and provide direct access to the stomach or small intestine. These tubes can be used for months or even years and can be removed as needed.

It is important to note that short-term feeding tubes can cause permanent damage to the larynx and tissues in the throat or esophagus if they are used for more than a few weeks, so it is important to follow the recommendations of a healthcare professional when determining the appropriate type of feeding tube for an individual.

Risks of Tube Feeding

Has the feeding tube been recommended for you or the person you care for by your healthcare professional?

This means that the body is not receiving nutrients by eating, so it needs this method to receive them. 

Feeding via enteral tubes can lead to some complications. Among the most common are:

  • Food is aspirated into the lungs through aspiration
  • When people are malnourished and begin receiving enteral feedings, they may experience refeeding syndrome, which can lead to dangerous electrolyte imbalances
  • The site of insertion of the tube may become infected
  • Symptoms of nausea and vomiting caused by eating too much or too fast, or by slow stomach emptying
  • Irritation of the skin near the insertion site of the tube
  • It is possible that diarrhea is caused by a liquid diet or medication
  • tube dislodgement
  • When tubes are not flushed properly, they may become blocked.     

Most complications associated with enteral feeding do not last for a long time.

It is normal to experience some digestive discomfort after resuming normal eating after a period of fasting.

What is the Best Way to Place Feeding Tubes?

Placing a feeding tube is a relatively quick medical procedure that is typically performed with the use of an endoscope. An endoscope is a thin, flexible tube with a lighted tip that is inserted through the mouth and into the stomach to allow the healthcare provider to see the area where the feeding tube will be inserted. In some cases, sedation or anesthesia may be necessary, particularly for individuals who are conscious and may experience discomfort during the procedure.

To place a feeding tube, the healthcare provider will make a small incision in the abdomen and pass the feeding tube through it and into the stomach. The tube is then secured in place with sutures or a special device. The incision should close tightly around the tube in a few days, and the tube can be used to administer nutrition, fluids, and medications directly into the stomach. If the skin around the incision becomes irritated or leaks fluid, an ointment can be applied to protect it. Generally, washing the site with soap and water will be sufficient for maintaining proper hygiene. It is important to follow the care instructions provided by the healthcare provider to ensure that the feeding tube is properly maintained and to prevent any complications.

Feeding Tube Removal Procedure

There are two techniques for removing the feeding tubes: temporarily or permanently.

Temporary Removal of Feeding Tubes

Removing a temporary feeding tube is an easy and quick process. It is very rare for mouth, nose, or throat irritation to occur.

Food and fluids are emptied from tubes using syringes. The tube is withdrawn a few seconds later, then verified to have been safely withdrawn.

Removing the Feeding Tube Permanently

People with permanent tubes may still be able to eat and drink normally, even though their tubes are permanent. If you have not maintained your weight for a month, your healthcare provider may require more time before removing your feeding tube. 

The force required to remove temporary tubes is greater than that required to withdraw from them. You may also experience more pain, as well as lose a little blood as a result. There is a quick resolution to these issues.

Sum Up

The food, fluids, and medications that are needed by people who can’t swallow are administered through feeding tubes. The need for tubes may be temporary or result from chronic conditions such as cancer or strokes.

A tube type will be chosen based on the condition and the length of the tube. Short-term tubes, like NG and OG tubes, must be removed within a few weeks, otherwise, permanent damage will occur. Tubes that are intended to remain in place for long periods of time, such as G tubes and J tubes, may also be removed later.

While the removal of a long-term tube can cause some minor effects, the procedure for placing and removing them is straightforward.

FAQ:

How Is Nutrition and Hydration Delivered through a Feeding Tube?

Nutrition and hydration can be delivered through a feeding tube using a special pump or syringe. The frequency and amount of nutrients and fluids administered will depend on the individual’s specific needs and will be determined by a healthcare professional.

Can a Person Eat or Drink While Using a Feeding Tube?

It depends on the type of feeding tube being used. Some feeding tubes, such as nasogastric tubes (NG tubes) and orogastric tubes (OG tubes), are inserted through the nose or mouth and allow for some limited oral intake. Other types of feeding tubes, such as gastric tubes (G tubes) and jejunostomy tubes (J tubes), bypass the mouth and throat entirely and do not allow for oral intake.

Can a Feeding Tube Be Removed?

Yes, feeding tubes can be removed if they are no longer needed or if the individual is able to eat and drink on their own again. The process for removing a feeding tube depends on the type of feeding tube being used and may involve simply pulling the tube out or a more complex surgical procedure.

What Are the Risks of Using a Feeding Tube?

 As with any medical procedure, there are risks associated with using a feeding tube. These may include infection, bleeding, and damage to the tissues in the nose, mouth, or throat. 

How Is a Feeding Tube Cared For?

 Proper care of a feeding tube is important to ensure that it remains functional and to prevent complications. This may involve cleaning the skin around the tube, replacing the tubing, and checking the tube for kinks or blockages. Salamati Team is well-trained to take care of any type of feeding tube you have.

 



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