Tube feeding | Artificial nutrition

On this page, you’ll find a comprehensive overview of feeding tubes, including how they function, the reasons someone might need one, and the differences between enteral and parenteral nutrition. I’ll also cover the various types of feeding tubes and share five essential tips for living with a feeding tube.

How it works

Tube feeding is a medical method used to provide nutrition to individuals who are unable to eat by mouth. In this process, a tube is inserted directly into the stomach or intestines, allowing for the delivery of specially formulated liquid food. This liquid food contains all the essential nutrients, including calories, vitamins, and minerals, necessary to maintain health and well-being. By using tube feeding, healthcare providers can ensure that patients receive adequate nutrition to support their body's needs, promoting strength and overall health even when normal eating isn't possible.

 

Why Someone May Need It

People may need tube feeding for many reasons, such as:

• Difficulty swallowing due to an injury or illness

• Digestive problems that make it hard to eat or absorb nutrients

• Conditions like cerebral palsy or stroke that affect the muscles used for eating

• Severe malnutrition or significant weight loss due to a chronic illness

Enteral vs. Parenteral Nutrition

There are two main types of nutrition support: enteral and parenteral.

·       Enteral Nutrition: This is when food is given directly into the stomach or intestines using a tube. It’s usually preferred because it uses the digestive system, which is the natural way to absorb nutrients.

·       Parenteral Nutrition: This is used when the digestive system isn't working properly. Nutrients are given directly into the bloodstream through a vein (intravenously or IV). This method is more complex and is used only when enteral feeding isn’t possible.

 

Different Types of Tubes

There are several types of feeding tubes:

·       NG-Tube (Nasogastric Tube): This tube goes in through the nose, down the throat and into the stomach. This tube is used when the stomach can’t tolerate food or needs to be bypassed, often in cases of severe reflux or gastroparesis (slow stomach emptying). This is usually a shorter-term solution, often used for people who need feeding support or to remove stomach contents and can be placed at the bedside.

·       NJ-Tube (Nasojejunal Tube): This tube is like an NG tube but goes further, passing the stomach and into the small intestine (jejunum). This tube is used when the stomach can’t tolerate food or needs to be bypassed, often in cases of severe reflux or gastroparesis (slow stomach emptying). This must be placed in endoscopy or invasive radiology.

·       PEG tube (Percutaneous Endoscopic Gastrostomy Tube): This tube is placed directly into the stomach through a small incision in the abdomen, usually in endoscopy or radiology. This tube is used for long-term feeding, often for people who have chronic conditions that prevent them from eating normally.

·       PEG-J tube (Percutaneous Endoscopic Gastrostomy-Jejunostomy Tube): This tube starts as a PEG tube but includes an extension that goes beyond the stomach and into the small intestine (jejunum), again usually placed in endoscopy or radiology. It allows access to the stomach for venting or draining and provides a means to feed into the small intestine. However, these tubes can be more temperamental as the jejunal extension may occasionally flip back into the stomach.

·       J-Tube (Jejunostomy Tube): This tube is placed into the small intestine (jejunum) through the abdomen. It’s used as a long-term measure when the stomach needs to be bypassed, in cases such as severe gastric/pancreatic disorders, or when gastric feed is not possible. A J-tube placement requires surgery and is more complex than a G-tube because it requires accessing the small intestine, involves more precision, and has higher risks of complications.

·       Central Line: A central line is a long, thin tube placed into a large vein near the heart. There are various types of central lines, including PICC lines, Hickman catheters, and ports. These are used for parenteral nutrition, where nutrients are given directly into the bloodstream. It’s used when the digestive system can’t handle food at all, often due to severe digestive issues or bowel surgery. This is usually placed in invasive radiology.

 

5 Top Tips for Living with a Feeding Tube

1.    Seek Support; Connect with support groups or online communities to share experiences and gain insights, communicate openly with friends and family about how you feel and don’t hesitate to seek help from healthcare professionals when needed.

2.    Embrace the Positive: Understand that having a feeding tube is a significant adjustment, but many people live full, active lives with one. For most, it restores a quality of life that would otherwise be unattainable.

3.    Stay Informed: Learn about your specific type of feeding tube, including its use, care requirements, and how to order supplies. It’s also vital to know how to manage common issues and who to contact for help or advice.

4.    Maintain Hygiene: Always keep the feeding tube and insertion site clean, wash your hands thoroughly before handling the tube and use techniques taught by medical professionals when handling feeds, water, or medications.

5.    Be Prepared: Always carry extra supplies, such as syringes and tape, when you go out.

Having the necessary items on hand ensures you can handle any issues that arise with your tube.

Living with a feeding tube may take some getting used to, but with the right care and support, it can help you stay healthy and active. For more information on tube feeding, you can sign up to PINNT, a charity dedicated to providing support for people on home artificial nutrition.

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