Protocol for the Use of Enteral Feeding Tubes
Enteral feeding tubes are devices designed to provide nutrition to people who are either unable or unwilling to eat normally. Candidates for enteral feeding include people suffering from comas, severe malnutrition, liver failure and long-term anorexia. Enteral tubes come in several different forms, and use of the devices follows well-established medical protocols.
If you require an enteral feeding tube, the type used will be determined in part by how long enteral feeding is necessary, according to the Merck Manuals Online Medical Library. If you need a feeding tube for less than four to six weeks, you will probably receive a nasoenteric tube, which will pass through your nose down into your gastrointestinal tract. This type of device is also called a nasogastric tube and is made from small-gauge polyurethane or silicone tubing. If you suffer from nasal blockages or deformities, a similar type of tubing can be placed in your mouth.
If you need a feeding tube for longer than four to six weeks, you will probably receive one of two types of enteral devices designed for more permanent placement. Gastrostomy tubes are placed through your abdominal wall directly to the interior of your stomach. Jejunostomy tubes are inserted through your abdomen into a segment of your small intestine called the jejunum. Generally speaking, gastrostomy tubes are preferred unless there is a blockage or other complication in your stomach area. They are more stable than jejunostomy tubes and provide more freedom of movement. If you receive a jejunostomy tube, your doctor will need to check its placement regularly to make sure it has not dislodged from its intended location.
Once your tube is in place, you can be fed either several times throughout the day or through a continuous drip. If you receive individual feedings (called bolus feedings), your daily food intake will be split into four to six portions and either injected into your tubing by a syringe or introduced by gravity from an elevated feeding bag. To avoid potential complications such as pneumonia, you will need to sit upright both during your feeding and for one to two hours afterward. Depending on your needs, your feeding may consist of individual packs that contain only one type of nutrient or formulas that contain a mixture of nutrients.
If you are fed through a nasoenteric tube, you may initially experience bouts of diarrhea. To offset this possibility, your doctor will typically dilute your feedings at first, then concentrate them as your body adjusts to treatment. If you are fed through a jejunostomy tube, your feedings will be diluted initially and also given in small portions. As your body adjusts, higher concentrations and greater amounts can be given, but these are still typically lower than those given to patients with gastrostomy tubes.
Consult your doctor for more details on the use of enteral feeding tubes.