Feeding Tube can be used to feed people whose digestive tract works normally but cannot eat enough to meet their nutritional needs. Those with any of the following cases are included:
- Lack of appetite for a long time
- Severe protein-energy malnutrition (a strong deficiency of protein and calories)
- Comma or very reduced alertness
- Liver failure
- Head or neck injury or other disorder that makes them unable to eat by mouth
- A serious illness (such as burns) that increases nutritional needs
In case of serious illness or malnutrition, tube feeding can be introduced before surgery.
Compared to intravenous feeding, tube feeding has the following advantages:
- The structure and function of the digestive tract are better preserved.
- The cost is lower.
- It probably causes fewer complications, particularly infections.
In general, the place where the probe is inserted depends on the length of the necessary feeding probe:
- For a period of less than 4 to 6 weeks: a thin plastic tube is passed through the nose and throat until it reaches the stomach (called the nasogastric tube) or the small intestine (called the nasoduodenal tube). If the nose is damaged, the tube can be inserted through the mouth.
- For more than 4 to 6 weeks: the tube is placed directly in the stomach or small intestine; To do this, a small incision is made in the abdominal wall.
Insertion of a feeding tube through the nose
Nasogastric and nasoduodenal probes can usually be inserted while the person is awake. The probe is lubricated and inserted through the nose and through the throat. It can cause retching and nausea when it enters the throat, so the person is asked to swallow or give water with a straw to help with swallowing. Swallowing may decrease or prevent retching and nausea and helps to pass the tube through the throat. Once the tube has passed through the throat and enters the esophagus, it can easily slip into the stomach or small intestine. Sometimes doctors do tests, such as an x-ray of the abdomen, to make sure the tube is positioned correctly.
Insertion of a feeding tube directly into the stomach or intestine
When a feeding tube is inserted directly into the stomach or small intestine, a percutaneous endoscopic gastrostomy tube is usually used.
Before the insertion of the PEG probe, a sedative is given to the patient and sometimes an analgesic, usually intravenously. The back of the throat can also be sprayed with a numbing spray to suppress the need to cough or retching and gagging. Doctors then insert an endoscope through the mouth to the stomach or small intestine, with a camera at its tip, which allows them to see inside the stomach and determine where to place the PEG probe. Then they make a small incision in the abdomen and insert the PEG tube. People should fast before the procedure, and food and liquid intake are limited once the test is over until the gag reflex returns.
If a PEG tube cannot be placed, a surgical procedure can be used to help doctors insert the feeding tube directly into the stomach or small intestine. This procedure can be carried out in one of the following ways:
- Using a vision tube (laparoscope), for the introduction of which only a small incision just below the navel is required.
- Making a relatively large incision in the abdomen if doctors need to see the area through the incision in order to place the tube in the right place.
After inserting a feeding tube
People with feeding tubes should remain seated in an upright position or with the head of the bed raised during feeding and 1 to 2 hours later. This position reduces the risk of food being inhaled and allows gravity to help move food through the digestive tract.
Usually, a relatively large amount of food (called bolus) is given several times a day. However, if these intakes cause nausea, small amounts of food are continuously given.
There are different formulas for administration by feeding tube; Usually, one that provides a complete and balanced diet is used. Some are designed to treat a specific deficiency and may contain a single nutrient, such as proteins, fats or carbohydrates.
There are also specialized formulas available for people with specific needs. The following are included:
- Concentrated formulas, with less liquid volume, for people whose fluid intake is limited
- Formulas enriched with fiber, for people with constipation
- Lactose-free formulas, for people who are lactose intolerant
Complications arising from the use of a feeding tube are common and can be serious.