The common idea about Enteral feeding

The lexicographic reference to the ‘enteral’ says that enteral refers to the path that involves the mouth, esophagus, stomach, and intestines. To the medical world, however, where this term is most commonly in use, it refers to tube feeding. Tube feeding is resorted to during conditions where normal feeding is hampered due to some medical condition or injury. Especially when the mouth is dysfunctional whereas the GI tract is still able to function, enteral feeding helps.

Conditions, when Enteral Feeding is advised to a patient

The GI tract is a totality of the mouth, esophagus, stomach, and intestines respectively. Impairment or injury in the first phases, that is the mouth or say, throat (esophagus lies within), hampers normal feeding. Consequently, the fear of insufficient feeding, malnutrition, lesser calorie intake, weight loss, and serious health issues creep in.

Now, the various conditions that could lead to an 'enteral feeding' being prescribed are:

• Cancer in the mouth or throat that could make eating difficult. This deadly disease in other parts of the body like, say, the brain or the lungs causes extreme fatigue, weakness, and vomiting that makes the patient unable to eat properly.

• A serious injury to the mouth or other facial parts that affect normal eating.

• A stroke that may impair the ability to swallow

• Often young children and infants face difficulty in eating. At an age when nutritional intake is most essential, such kids run the risk of going undernourished or malnourished. Enteral feeding is prescribed in such cases too.

• Patients in an unconscious or subconscious state are advised enteral feeding.

• A neurological or movement disorder that could make it more difficult to eat while caloric intakes become most essential.

However, if the patient suffers from a GI dysfunction or disease, an intravenous (IV) nutrition is required and the patient can no longer be put on enteral feeding.

The different procedures to let the tube enter

Tubes can be nasogastric (NGT) or orogastric (OGT). That is, to put it simply, it can enter through the nose or the mouth with its other tip ending in the stomach. Ideally, anesthesia isn’t required for inserting the tubes. The tip of the tube is lubricated, and the nurse’s expert hands slide it down through the nasal passage or the oral cavity. Outside, it is attached to the skin using soft tapes.

You must be wondering how is it ensured that the pipe enters the right location? This is rather simple.

The doctor or nurse performing the job pulls some gastric juice, using the suction technique, checks its pH in order to confirm that the tube is in the stomach. Basically, the acidity level of the liquid is used to determine the correctness of its position.

In case the same is not confirmed, professionals could resort to an X-ray too.

What is the endoscopic placement of an enteral tube?

When the feeding tube is placed using an endoscope – a thin tube that is fitted with a tiny camera at the end, the process is known as endoscopic placement. Once the endoscope is removed, verifications using the X-ray method and suction of gastric contents are made. Ideally, if the position is not right, one needs to wait at least 4 to 12 hours before placing a new feeding tube.

Does the patient remain conscious?

A common concern among people who undergo any medical procedure is that whether it is done in the conscious or unconscious state. Well, normally feeding tube insertion is done in a conscious state or might be in a state of conscious sedation. This usually depends on his or her medical condition. If normal gastroenteric or oroenteric feeding is not possible, the doctor or nurse might resort to Gastrostomy or Jejunostomy.

What is Gastrostomy or Jejunostomy?

Placement of gastrostomy or jejunostomy tubes involves conscious sedation. Occasionally, general anesthesia may also be used. A tiny cut is made in the abdomen to place the tube in the abdomen or intestine, whereby, an endoscope is used to see where the tube should enter. Thereafter, it is secured to the skin using tapes.

Although the recovery procedure after a jejunostomy or gastrostomy might take 5 to 7 days, yet, the incision is very small; so, it typically heals sooner. Usually, antibiotics are used to prevent infection.

What is Parenteral feeding and when is it resorted to?

When Enteral feeding does the job, what the need for parenteral feeding at all? Medical conditions are innumerable, and the situation may vary from person to person. A patient could be suffering from an ailment that makes his or her GI system non-functional. This is when parenteral feeding is needed.

Precisely, parenteral feeding is getting nutrition through the veins. Venous access is made with the help of a peripherally inserted central catheter. This is referred to as the PICC or PIC line.

When the inserted device is being used to provide you with supplementary nutrition as otherwise, you would have undergone insufficient nutrition, it is known as PPN (Peripheral Parental Nutrition). If the pathway is used for all nutritional inputs within your body, it is known as TPN (total parental nutrition).

Evidently, parenteral nutrition is mostly lifesaving. If possible, enteral nutrition should preferably be accessed; since it mimics regular eating closely, it helps the digestive and your immune system function normally!

Things to be aware of while on enteral feeding?

• While you’re taking care of a patient or an elderly member at home, who is on enteral feeding, acquaint yourself with certain possible complications that you might have to handle any moment!
• The patient might aspirate; In simpler terms, the food might enter the air passage
• Highly malnourished individuals who start receiving enteral feeds suddenly, run the risk of undergoing dangerous electrolyte imbalances. This is known as ‘Refeeding Syndrome’.
• Nausea and vomiting tendencies due to too large or fast feeds.
• Skin irritation on account of the insertion of the tubes.
• Tube blockage could also occur if there have not been proper and enough flushing. For this, the user or the caretakers of such patients are to use an effective Enteral Feeding Tube Declogger Kit in order to ensure proper cleaning of the tube for its perfect functioning.
• Diarrhea due to some specific medications and/or a liquid diet.

In a nutshell, enteral feeding is mostly used on a short-term basis. Especially, if the patient needs to recover from any illness, injury, or some surgical intervention, the doctor advises an enteral feeding.

These are the times when one needs an extra dose of nutrition. Gradually, these individuals return to regular eating.

However, on a long-term basis too, enteral feeding is used. People or children with physical disabilities, movement disorders, and such other inherent complications are put on long-term enteral feeding.

Sometimes, simply to prolong life in case of an older person who is unable to meet his or her proper nutritional needs, tube feeding is used.

Switching over to enteral feeding could be a tough adjustment at times. You will need both time and patience to acclimatize to the new changes that need to be adapted. Your doctor, nurses, nutritionist – all help you make this adjustment a successful one!

The list of medical products concerned with enteral feeding alone is indeed a long one. To avail any of these or know more about their functionality you can just check our enteral feeding supplies!