Tube Feeding (Enteral Nutrition)

What is tube feeding?

Tube feeding is a therapy where a feeding tube supplies nutrients to people who cannot get enough nutrition through eating. A flexible tube is inserted through the nose or belly area to provide nutrients by delivering liquid nutrition directly into the stomach or small intestine.

Doctors usually insert the tube while you are in the hospital, but you may continue to use it outside the hospital, at home, or in a nursing facility.

Tube feeding is also known as enteral nutrition and if provided at home, is termed home enteral nutrition (HEN).

Why is tube feeding used?

Tube feeding can help people who have trouble eating get the nutrition they need. Doctors often use it at the end of life to help people stay more comfortable, though some patients choose to opt out of tube feeding.

It is not recommended for patients with severe dementia and in some cases where aggressive medical treatments are not called for.

Your doctor may recommend enteral nutrition if your gastrointestinal tract (digestive system) works, but you cannot eat due to another disorder that affects your appetite or ability to chew or swallow.

Conditions that may lead your doctor to recommend a feeding tube include:

• Gastrointestinal dysfunction
• Head and neck cancers that make swallowing difficult or require throat surgery
• Gastrointestinal issues such as an obstructed bowel
• Neurological disorders including stroke and paralysis

What should I expect from tube feeding?

Doctors use different types of feeding tubes for HEN. The type of tube depends on the feeding route (stomach or small intestine) solution and how long you will receive this type of nutrition. Tubes can be:

• Nasally placed: A doctor inserts a tube through your nose and passes it through your throat into your small intestine (nasojejunal) or stomach (nasogastric). Doctors usually recommend this type of tube for people who will use a feeding tube for less than 6 weeks.
• Surgically placed: A doctor makes a small incision (cut) in your belly and inserts the tube into the small intestine (jejunostomy) or stomach (gastrostomy). Doctors usually recommend this tube for people who need feeding tube/enteral access longer than 4-6 weeks.

After your doctor inserts the tube, you will receive instructions on how to care for it. Your doctor will also tell you what kind of tube feeding formula to use to receive proper nutrition.

What are the risks of tube feeding?

The risks of home tube feeding are small, but complications can occur. These complications may include:

• Clogged, damaged or displaced tube
• Infection at the tube insertion site
• Gastrointestinal problems including constipation, nausea and diarrhea
• Leaking of stomach contents at the tube site
• Pain at the tube site

What is the prognosis (outlook) for people who use tube feeding?

The length of time enteral nutrition lasts varies by the person. Depending on the reason for the tube, people may use a feeding tube for a few weeks, several months, or years.

In some cases, people use a feeding tube for the rest of their lives after surgery or an injury impairs their ability to receive enough nutrition through eating.

When should I call my doctor?

It’s important to take care of your feeding tube the way your doctor instructs you and to keep your insertion site clean. If you have pain, redness, swelling, excessive itching or leaking, call your doctor.