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What is enteral feeding and why do I need a feeding tube?
Enteral feeding, or tube feeding, is required when you cannot get enough nutrients by mouth, but your stomach and/or bowels (intestines) are still working. This may mean you’re having trouble eating, chewing or swallowing, not maintaining weight, or are unable to eat or drink enough to get the proper nutrition and fluids without assistance or choking.
A number of diseases and medical conditions, and sometimes their treatments, can lead to poor nutrition and the need for enteral feeding.
If you’re having problems eating or drinking and have lost 5 to 10 percent of your body weight, your doctor may order a feeding tube so you can get the proper nutrition and fluids to prevent weight loss, dehydration and other health complications that may be a result of an illness or medical condition.
Your doctor will select a tube based on a few different factors, such as how long you need a feeding tube and which tube would work best with your anatomy and feeding needs. Lifestyle factors should also be considered. You should talk with your doctor about your options.
Conditions that can require a feeding tube
Among the conditions that can require you to need a feeding tube, are GI (stomach) diseases, cancer and its treatments–such as surgery, chemotherapy and radiation—neurological (brain) diseases and neuromuscular (muscle) diseases, problems from birth, as well as growth and development challenges. Strokes, burns, brain injuries, cerebral palsy, Parkinson’s and dementia are also conditions in which you may need assistance with eating through a feeding tube, either temporarily or permanently.
Although the idea of a tube, whether for you or a loved one, may make you feel anxious or even scare you, feeding tubes are just another way to receive necessary nutrition. There are many people around the world who participate in everyday activities both socially and physically, who are tube fed. There are also many instances where you may still be able to receive some nutrition by mouth, while you have your tube, and in other cases, where you may only have a tube for a temporary time frame—days, weeks, or years—but can eventually stop using it. It’s important to find support, whether through your care team, family, or tube feeding advocacy groups to help you throughout your journey. Always remember—you don’t have to do this alone!
How does a feeding tube get placed?
How your tube is placed will depend on the type of tube you’re getting. Some tubes do not require surgery or anesthesia, while others require both. Some tubes can be replaced by a trained caregiver at home, while others can only be replaced by a physician. It is also common to change tube types if long-term feeding is necessary. For example, you may move from a PEG tube to a balloon retained tube, or from a standard-length tube to a low-profile tube. Your physician may also decide to change the type of tube to feed into a different part of your anatomy, such as going from a G tube to a J tube.
Either your general care doctor or your specialist should discuss this process and the options with you. Initial placement of a feeding tube often requires a multi-day hospital stay, while replacement tube placements are typically an outpatient procedure that takes 30 minutes to an hour.
It's important to find support, whether through your care team, family, or tube feeding advocacy groups to help you throughout your journey. Always remember—you don't have to do this alone!
Using a feeding tube
After your feeding tube is placed you will likely meet with a clinician or dietitian to show you or your caregiver how to use the tube for feeding. You will also be instructed on caring for the tube. Stoma site care will also be taught if the tube was placed via a gastrostomy (a surgical opening through the skin into the stomach).
Using a feeding tube will take some adjustment. They can initially be cumbersome or uncomfortable. They require cleaning and maintenance after each use that you or your caregiver will have to learn. And they may require other adjustments like sleeping on your back or side, and not eating certain foods by mouth.
A feeding tube can be used to deliver all your nutrition, fluids, and medications if needed. Many people use a tube but can still eat and drink some things orally.
You can also maintain a normal life and participate in most activities you did prior to getting a feeding tube, including going out, working, seeing friends, exercising, swimming and enjoying sex.
Feeding Tube Removal
Feeding tubes sometimes come out accidentally, are removed for routine replacement, or are removed permanently.
If you’ve received a tube for the first time or received a new type of tube, your care team will instruct you what to do if your tube accidentally comes out. Stomas that aren’t mature yet can close quickly, in some cases within an hour or two, so it’s important that if the tube comes out, you work to quickly follow their guidance. Mature stomas can still close, but the window of time may be greater. Always be prepared and aware of the plan should any accidental dislodgements happen.
Some tubes may be routinely replaced. Depending on the type of tube you have and the instructions from your care team, you may be able to replace the tube yourself or may be required to come in, so your physician can change it.
And in some situations, a feeding tube is no longer required. If this is the case, your physician will instruct you on what to do.