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nutrition is a way to provide nutrients through a tube placed into the
gastrointestinal tract and is often referred to as "tube feeding"
The need for enteral nutrition arises when a patient is unable to
ingest or tolerate an oral diet and its use may be short or long in
duration. A tube placed through the nose is called a nasogastric tube
(NG tube), through the skin to the stomach is a gastrostomy tube (G
tube) or percutaneous endoscopic gastrostomy tube (PEG tube), or into
the small intestine is a jejunostomy tube (J tube).
There are several diagnoses that may require the use of enteral nutrition.
Swallowing is a complicated biological process. The inability to
swallow appropriately, known as dysphagia, may result in aspiration of
food into the lungs. Cancer of the esophagus or stomach may prohibit
food from entering the gastrointestinal tract. Short bowel syndrome or
malabsorption may result in prolonged nutrient loses. Burns, surgery,
infection, trauma, or illness or a diagnosis of failure to thrive my
increase caloric needs while impairing intake and retention of
Enteral nutrition has risks and complications associated with its use.
Mechanical complications are the most common. The feeding tube can
become obstructed, inhibiting the flow of nutrition. Infection at the
site of tube entry is a persistent risk. The patient may also have
difficulties with maintaining electrolyte balance and adequate
hydration. Patients receiving enteral nutrition may also experience
esophageal reflux, aspiration, refeeding syndrome, and diarrhea.
Administration may be accomplished via bolus feedings, gravity, or by use of an enteral pump.
Bolus feedings are administered by slowly pouring the prescribed amount
of formula into the barrel of a special syringe attached to the opening
of the tube and allowing the formula to flow into the tube. Using an
attached bag system to contain the liquid diet for feeding is a
secondary method by which food is allowed to drip slowly into the tube
though “gravity feeding”. Often, the rate of flow of the formula is
controlled by an enteral pump. When feeding the patient, it is
imperative that the caregiver or patient thoroughly wash their hands
with soap and water before preparing formula or having contact with the
feeding tube. The tube should be checked for patency, and the formula
administered at room temperature. The patient should be upright, no
less than thirty degrees, to minimize the risk of regurgitation and
aspiration, and they should be kept upright for thirty to sixty minutes
after feeding. To prevent complications (abdominal cramping, nausea and
vomiting, gastric distension, diarrhea, aspiration), food should be