Tube Feeding

What is tube feeding?

Tube feeding is a liquid food mixture given through a tube when you are not able to take in enough nutrition to meet your body’s needs. It is also called enteral nutrition.

Tube feeding may be temporary or permanent. Some people need tube feeding while they are getting better during an illness. Other people may need to have tube feedings for the rest of their lives.

When are tube feedings used?

If you cannot eat in the usual way, you may not be getting enough nutrition for good health. For example, you may need tube feeding if:

  • You cannot swallow safely because you have a disease or injury that affects your mouth or throat, such as cancer or having had a stroke.
  • You are receiving medical treatment, such as chemotherapy or radiation therapy, or have an illness that temporarily makes it hard for you to eat enough food.

How does tube feeding work?

A dietitian figures out the amounts of vitamins, minerals, fluids, and calories you need each day. Then the dietitian chooses the right formula to meet those needs. The formula may be one you can buy at the store, or you may be able to make the formula at home.

Formulas may be given in 2 ways:

  • Bolus feedings give large formula doses several times a day, similar to eating at mealtimes. The formula can be pushed through the tube by a pump, or it can be put into the tube with a syringe.
  • Continuous feedings steadily drip small amounts of formula through the tube over several hours or all the time.

How are the tubes placed?

The tubes are soft and flexible. They may be placed in different ways:

  • Nasogastric tubes: Your healthcare provider will insert the tube into your nose or mouth and gently push it down into your stomach or past your stomach to your small intestine. Nasogastric tubes may be used when tube feeding is needed for only a short time (days or weeks).
  • Gastrostomy tubes: For this type of tube feeding, you are given an anesthetic so that you will not feel any pain. Your healthcare provider will place a feeding tube into the stomach through a cut in your belly. A balloon or rubber cap keeps the tube in place in your stomach. Gastrostomy tubes are used when tube feeding is needed for months or more. They are more comfortable than nasogastric tubes.

The tube can usually be used for feeding within 12 to 24 hours after if has been placed. You or your caregiver may be taught how to use and care for the feeding tube at home.

The tube will be changed if it gets plugged or may be changed on a regular schedule. Replacing a tube can be done in your healthcare provider's office.

Are there any problems with tube feeding?

Some of the problems that might happen with tube feeding are:

  • Your bowel movements may be looser, or you may have constipation. Changing formulas or giving less food at one time can usually help this problem.
  • The tube may get clogged or shift into the wrong place. If a nasogastric tube is pulled out too far, formula can get into your lungs and cause pneumonia.
  • Your body may absorb too much or too little of various nutrients. Your healthcare provider or dietitian can help with this.
  • You may feel self-conscious about eating in a different way than other people. You may need extra equipment in your home for the feedings. You may need help in preparing or getting the feedings and may not like feeling dependent on someone else.
  • If you can no longer enjoy tasting, chewing, and swallowing a variety of foods, you may feel angry, sad, or depressed.

Can I refuse to be fed with a tube?

Any competent adult can accept or refuse tube feeding. You are legally competent if you are at least 18 years old and able to understand choices and make decisions. You are presumed competent unless a judge has declared you incompetent. If you are not able to make your own decisions, your healthcare provider will ask your family, legal guardian, or healthcare power of attorney to make the decision about tube feeding.

Once the treatment is started, you can decide to stop the treatment at any time. Since not getting food and fluids over time will cause death, refusing tube feedings is often a hard decision for you and your family. You might want to sign an advance directive that says whether or not you want tube feeding.

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