Although we accept enteral feeding by tube aspart of our standard armamentarium of methods torestore or preserve nutrition health in chronically orcritically ill patients, feeding by tube has had anuneven history over thousands of years. The earliestrecorded description of feeding nutrients by tubewas found in papyrus from 3500 years ago.1AncientEgyptians and Greeks used enemas to infuse nutri-ents to preserve health, protect an inflamed bowelsurface, or treat diarrhea.2,3Infused solutions weremade from wine, milk, whey, and wheat or barleybroths. Eventually, eggs and brandy were added tothis mix. Rectal feeding was the artificial feedingmethod of choice for thousands of years due to the
Full Answer
When is a feeding tube used as a treatment?
When the underlying cause of the inability to swallow is thought to be reversible, the feeding tube is used as a treatment. At some times the problem will be caused by surgery or by a stroke and recovery is expected.
What is the state of being fed by a feeding tube?
The state of being fed by a feeding tube is called gavage, enteral feeding or tube feeding. Placement may be temporary for the treatment of acute conditions or lifelong in the case of chronic disabilities. A variety of feeding tubes are used in medical practice. They are usually made of polyurethane or silicone.
Can a debilitated patient be deprived of a feeding tube?
They should not be deprived of this for the convenience of a feeding tube. The burdens of a feeding tube include the minor discomfort of its insertion and diarrhea that is often caused by tube feeding. In a debilitated patient who is not able to get prompt nursing care, diarrhea may increase the incidence of skin break down or bedsores.
What is GI surgery feeding tube?
GI surgery. People who have surgery on their throat or stomach often have a feeding tube while recovering from surgery; a tube leading through the nose and down to the middle part of the small intestine is used, or a tube is directly placed through the abdomen to the small intestine.
What is a feeding tube?
What are the conditions that require tube feeding?
How long does a nasogastric tube last?
What are the different types of feeding tubes?
Why are feeding tubes used in the ICU?
Where is the nasojejunal tube?
Where is the feeding tube inserted?
See more
About this website
Is a feeding tube considered medical treatment?
Abstract. Tube feeding is now legally regarded as medical treatment. The provision of nutrition through nasogastric or gastrostomy feeding tubes is not part of basic care according to several recent court decisions.
When did feeding tubes start?
Although supplemental enteral nutrition may have first been delivered by enema, the modern era of surgically placed feeding tubes began in the mid to late 1800s.
Is having a feeding tube considered a disability?
Children with feeding tubes are typically considered children with disabilities, and are therefore covered by of the Americans with Disabilities Act.
Is a feeding tube considered life support?
Tube feeding is not considered a basic part of care. Health care providers, ethicists and the courts consider it to be artificial nutrition and a medical treatment. This makes it comparable to other medical treatments such as dialysis or assisted breathing.
Who introduced tube feeding?
John Hunter, a Scottish surgeon and comparative anato- mist who practiced in England, created an orogas- tric tube made of whalebone covered with eel skin. Gastrostomy as a surgical procedure was proposed by several surgeons, including Charles Sédillot, a French surgeon, in 1846.
Is there an alternative to a feeding tube?
A: Though it is much more time-consuming, hand feeding appears to be a better alternative than tube feeding for older adults with advanced dementia. Tube feeding probably reduces the risk that food will end up in the lungs and cause pneumonia.
What is the life expectancy of a person with a feeding tube?
Patients who receive a percutaneous feeding tube have a 30-day mortality risk of 18%–24% and a 1-year mortality risk of 50%–63%. In a well-designed prospective study, Callahan et al. followed 150 patients with new feeding tubes and varied diagnoses, and found 30-day mortality of 22% and 1-year mortality of 50%.
How long can a person live with a feeding tube in their stomach?
A feeding tube can remain in place as long as you need it. Some people stay on one for life.
What is a permanent feeding tube called?
Long Term Feeding Tubes Jejunostomy tube (J tube): Like the G tube, the J tube is placed through an incision in the abdomen.
What does the Catholic Church say about feeding tubes?
The church's view is that giving food and water to a person through a feeding tube is not medical intervention but basic care, akin to keeping the patient clean and turning him to prevent bedsores, Pacholczyk said.
Can you be forced to have a feeding tube?
Many treatment options Cases that involve force-feeding of people with anorexia through a nasal or stomach tube often get the most news attention. This type of treatment, though, falls at one extreme of a spectrum, from persuasion by family members or healthcare professionals to involuntary, legal action.
Are feeding tubes considered heroic measures?
Physicians are much more likely to decline “heroic” measures, such as CPR, mechanical ventilation, feeding tubes, etc. This comes as a surprise to the hosts and, presumably, to other non-physicians.
Living With a Feeding Tube: What It’s Like and How to Manage It
A feeding tube allows you to carry on your life when you no longer eat and drink normally. Learn what it’s like, and how to manage it.
What To Expect From A Feeding Tube Insertion Procedure
A healthy individual places food into their mouth, which they then chew and swallow. The food moves into the stomach from the esophagus, where it is digested and broken down before entering the small intestine for nutrient absorption.
Feeding Tubes: Placement, Complications, Care - WebMD
If you’re unable to swallow and eat and drink enough by mouth, you will need a feeding tube. Here’s what to expect.
Feeding Tube for Infants: Conditions, Procedure, and Risks
A feeding tube, also known as a gavage tube, is used to give nutrition to infants who cannot eat on their own. The feeding tube is normally used in a hospital, but it can be used at home to feed ...
What is a feeding tube?
A feeding tube is a medical device used to provide nutrition to people who cannot obtain nutrition by mouth, are unable to swallow safely, or need nutritional supplementation. The state of being fed by a feeding tube is called gavage, enteral feeding or tube feeding. Placement may be temporary for the treatment of acute conditions ...
What are the conditions that require tube feeding?
The more common conditions that necessitate feeding tubes include prematurity, failure to thrive (or malnutrition), neurologic and neuromuscular disorders, inability to swallow, anatomical and post-surgical malformations of the mouth and esophagus, cancer, Sanfilippo syndrome, and digestive disorders.
How long does a nasogastric tube last?
This type of feeding tube is generally used for short term feeding, usually less than a month, though some infants and children may use an NG-tube longterm. Individuals who need tube feeding for a longer period of time are typically transitioned to a more permanent gastric feeding tube. The primary advantage of the NG-tube is that it is temporary and relatively non-invasive to place, meaning it can be removed or replaced at any time without surgery. NG-tubes can have complications, particularly related to accidental removal of the tube and nasal irritation.
What are the different types of feeding tubes?
Types. The most common types of tubes include those placed through the nose, including nasogastric, nasoduodenal, and nasojejunal tubes, and those placed directly into the abdomen, such as a gastrostomy, gastrojejunostomy, or jejunostomy feeding tube .
Why are feeding tubes used in the ICU?
Feeding tubes are often used in the intensive care unit (ICU) to provide nutrition to people who are critically ill while their medical conditions are addressed; as of 2016 there was no consensus as to whether nasogastric or gastric tubes led to better outcomes.
Where is the nasojejunal tube?
A nasojejunal or NJ-tube is similar to an NG-tube except that it is threaded through the stomach and into the jejunum, the middle section of the small intestine. In some cases, a nasoduodenal or ND-tube may be placed into the duodenum, the first part of the small intestine. These types of tubes are used for individuals who are unable to tolerate feeding into the stomach, due to dysfunction of the stomach, impaired gastric motility, severe reflux or vomiting. These types of tubes must be placed in a hospital setting.
Where is the feeding tube inserted?
A jejunostomy feeding tube ( J-tube) is a tube surgically or endoscopically inserted through the abdomen and into the jejunum (the second part of the small intestine ).
Why are feeding tubes important?
While food and water are essential to life, there is considerable controversy in the medical literature as to how much artificial nutrition and hydration help at the time of death.
What happens if you use a tube feeding tube?
If the feeding tube is used in a patient who has a progressive terminal illness the tube may only delay death and the use of a feeding tube may simply prolong or increase the agony. The operative words are “progressive terminal illness,” which would include such conditions as cancer; kidney, heart, or lung failure. It would also include dementia and advanced age. It does not include someone who is stable though disabled after a brain injury or stroke. In the context of progressive terminal illness it can be argued that tube feeding should generally not be done. When the patient dies the ultimate cause of death is the underlying disease, not starvation or dehydration.
What is the benefit vs. burden of the feeding tube?
Medical decisions are often driven by the benefit of an intervention compared to its burden. What makes tube feeding unique is that the benefit may be huge while the burden is typically small .
Why discontinue feeding tube?
In the absence of a progressive terminal disease, the feeding tube may be used to prolong life. Since the patient is not dying of another cause, discontinuing the feeding tube would imply a desire to cause the patient’s death. It is in this context that most of the controversy occurs.
Why do you need to feed a tube after esophageal surgery?
Similarly, there are very few who would recommend tube feeding when the patient cannot eat because of an esophageal blockage caused by an untreatable cancer. ...
What are the burdens of a feeding tube?
Burdens of feeding tubes: The burdens of a feeding tube include the minor discomfort of its insertion and diarrhea that is often caused by tube feeding. In a debilitated patient who is not able to get prompt nursing care, diarrhea may increase the incidence of skin break down or bedsores.
How long does it take for a baby to swallow on its own?
Nevertheless, it may be appropriate to insert a feeding tube, hoping that perhaps within three months she will be stronger and able to swallow on her own. In three months, if she is not able to do that, we want to honor her wishes and discontinue the feeding tube.
What is the feeding process in tube fed infants?
The normal feeding process (hunger-satiation system) consists of three phases: (1) the pre-oral phase in which the child feels hungry, leading to appetite and nutritional intake; (2) the oro-pharyngeal phase in which the foods are prepared orally, transported from tongue to pharynx, and swallowed; and (3) the gastro-intestinal phase in which satiation and digestion occur [23, 32]. A normal feeding process requires a complex interaction between physiological (medical) factors (especially the cardiac, respiratory and digestive tracts are important), sensorimotor functions, and parental and pediatric factors [18, 23].
How long does it take to wean a child from tube feeding?
The transition from tube to oral feeding (weaning) may take only several days or weeks, but in others, it can be very challenging, lasting months to years [2, 18, 28, 39]. Since weaning can be very difficult, it is best accomplished with a multidisciplinary approach, including health care workers in the field of pediatrics, dietetics, psychology, speech-language pathology, and/or occupational therapy [15, 31, 38]. The pediatrician is responsible for the overall medical well-being of the child and will take care of medical problems, diagnostics, consultations, and medication. Furthermore, in most teams, the pediatrician coordinates the feeding team [15, 38]. The dietician monitors the nutritional intake including micronutrients and anthropometrics and will assist in developing a weaning plan [15, 18]. The psychologist determines the psychological and behavioral aspects of both child and their parents concerning feeding including cultural expectations, mealtime behaviors, and comorbid psychiatric diagnoses and can implement behavioral therapies [15, 38]. The speech-language pathologist will assess whether a child has the skills to feed itself safely and will therefore evaluate the oral motor feeding skills including swallowing. Furthermore, the speech-language pathologist can implement an oral motor program to improve swallowing or chewing coordination, treat feeding-related maladaptive behavior, and improve oral tolerance [15, 18]. In some feeding teams, an occupational therapist evaluates aspects concerning oral sensory, oral motor, and positioning of the child [15].
How to stimulate appetite during tube weaning?
Both boluses at daytime and continuous feeding at night can be used to stimulate appetite. When the child is on boluses at daytime, food should be offered orally before delivering the tube feeding to stimulate oral intake. On the other hand, feeding the child continuously by tube at night may stimulate oral intake during daytime. Another beneficial effect of nocturnal tube feeding is that the child is less aware of the tube feeding. When the child accepts some food orally, the total caloric intake of the tube feeding, which the child receives in 24 h, can be reduced to stimulate oral intake [28].
What is tube dependency?
Tube dependency is an unintended result of long-term enteral feeding [13] and is defined as the active refusal to eat (or drink), lack of motivation or inability to learn, or showing no precursors of eating development and skills after long-term enteral feeding [12, 15, 28]. The child consequently remains dependent on the feeding tube, although there are no medical grounds for the continuation of tube feeding anymore [12, 13].
Why is enteral nutrition important?
Eating and drinking are needed to sustain life and ensure growth [36]. Therefore, enteral nutrition might be needed when the child is unable to eat, malnourished, or when dietary measures are insufficient to fulfill nutritional requirements [18]. Although effective in these situations, when tube feeding lasts for a longer period, it can lead to difficulties in the transition to normal oral feeding and tube dependency when these children are medically stable [2, 28, 39].
How does tube feeding affect hunger?
Hunger-inducing methods for tube weaning are based on hunger induction given the fact that tube feeding reduces the child’s motivation to eat and drink. The control center for appetite is located in the hypothalamus, and appetite is stimulated by energy intake reduction, which will lead to feeding in healthy children within a few hours. Hunger requires a complex interaction of sensory input, limbic and cortical modulators, visceral feedback, and hormonal effects [37]. Rapid weaning of the tube feeding stimulates the experience of hunger, which is required to cure oral feeding aversion. Creating and stimulating hunger is the drive to start eating. This process is thought to become more complicated when tube dependency exists for a longer period [20].
What is an eating disturbance?
A. An eating or feeding disturbance (e.g., apparent lack of interest in eating or food, avoidance based on the sensory characteristics of food, concern about aversive consequences of eating) as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with one (or more) of the following:
When is a feeding tube necessary?
A feeding tube is necessary when you cannot safely take food or fluids by mouth. While it is possible to give fluid and nutrition through an IV, the body does better with food being delivered to the gut than into the blood vessels.
Why do people need feeding tubes?
A feeding tube is a medical device that is used to feed an individual who is unable to take food by mouth safely. This difficulty may be due to difficulty swallowing, an altered level of consciousness, an eating disorder, or other issues that make eating challenging. There are multiple types of feeding tubes and many reasons why a feeding tube may ...
What are feeding tubes good for?
Feeding tubes are good for more than providing food, they can also relieve gas and bloating and reduce nausea and vomiting. istockphoto. Common uses of a feeding tube include: Providing nutrition : Food, in liquid form, can be provided through a feeding tube. Tube feeding, or enteral nutrition, can be given through the tube to provide ...
Where is the J tube placed?
Jejunostomy tube (J tube) : This tube is placed through an incision in the abdomen that is lower than G-tube placement. It allows for direct access to the jejunum which is the middle third of the small intestine. 5 It tends to be smaller than the G-tube, which can limit what can be infused to thin liquids and finely ground powdered medications.
How to provide water to a patient?
Providing fluids: Water can be provided through a feeding tube to keep the patient hydrated without needing to give IV fluids.
Which tube allows for direct access to the stomach through an incision in the left upper side of the abdomen?
Gastric tube (G tube): This type of tube allows for direct access to the stomach through an incision in the left upper side of the abdomen. This tube completely bypasses the mouth and throat and allows for food, fluids, and medication to be given without swallowing.
How long does a feeding tube stay in place?
A temporary feeding tube, which is one that is inserted into the nose or mouth, down the throat, and into the stomach (G-tube) or deeper into the intestine (J-tube), can only safely stay in place for about 14 days.
Why do you need tube feeding?
Patients who may require tube feeding include those unable to take in an adequate supply of nutrients by mouth because of the side effects of chemotherapy or radiation therapy, those with depression or some other psychiatric disorder, and those suffering from severe hypermetabolic states such as burns or sepsis, or malabsorption syndromes. Other conditions that may require tube feeding include surgery or trauma to the oropharynx, esophageal fistula, and impaired swallowing such as that which occurs following stroke or that related to neuromuscular paralysis.
What is feeding in nursing?
feeding. [ fēd´ing] 1. the taking of food. 2. the giving of food. 3. in the nursing interventions classification, a nursing intervention defined as providing nutritional intake for a patient who is unable to feed self. artificial feeding feeding of a baby with food other than mother's milk.
What is the difference between a Dobhoff tube and a Drieling tube?
Dobhoff tube a small-lumen feeding tube that can be advanced into the duodenum. drainage tube a tube used in surgery to facilitate escape of fluids. Drieling tube a double-lumen tube having a metal weight at one end to carry it past the stomach into the duodenum.
What is the tube used for bronchial deflation?
endobronchial tube a single- or double-lumen tube inserted into the bronchus of one lung and sealed with an inflatable cuff, permitting ventilation of the intubated lung and complete deflation of the other lung; used in anesthesia and thoracic surgery. endotracheal tube see endotracheal tube.
What is Ewald tube?
Ewald tube a large lumen tube used in gastric lavage. fallopian tube see fallopian tube. feeding tube one for introducing high-caloric fluids into the stomach; see also tube feeding. tube feeding a means of providing nutrition via a feeding tube inserted into the gastrointestinal tract; it may be done to maintain nutritional status over a period ...
How many lumens are in a Minnesota tube?
Minnesota tube a tube with four lumens, used in treatment of esophageal varices; having a lumen for aspiration of esophageal secretions is its major difference from the sengstaken-blakemore tube.
What is artificial feeding?
artificial feeding feeding of a baby with food other than mother's milk. bottle feeding in the nursing interventions classification, a nursing intervention defined as preparation and administration of fluids to an infant via a bottle. breast feeding breastfeeding. enteral tube feeding in the nursing interventions classification, ...
What is a feeding tube?
A feeding tube is a medical device used to provide nutrition to people who cannot obtain nutrition by mouth, are unable to swallow safely, or need nutritional supplementation. The state of being fed by a feeding tube is called gavage, enteral feeding or tube feeding. Placement may be temporary for the treatment of acute conditions ...
What are the conditions that require tube feeding?
The more common conditions that necessitate feeding tubes include prematurity, failure to thrive (or malnutrition), neurologic and neuromuscular disorders, inability to swallow, anatomical and post-surgical malformations of the mouth and esophagus, cancer, Sanfilippo syndrome, and digestive disorders.
How long does a nasogastric tube last?
This type of feeding tube is generally used for short term feeding, usually less than a month, though some infants and children may use an NG-tube longterm. Individuals who need tube feeding for a longer period of time are typically transitioned to a more permanent gastric feeding tube. The primary advantage of the NG-tube is that it is temporary and relatively non-invasive to place, meaning it can be removed or replaced at any time without surgery. NG-tubes can have complications, particularly related to accidental removal of the tube and nasal irritation.
What are the different types of feeding tubes?
Types. The most common types of tubes include those placed through the nose, including nasogastric, nasoduodenal, and nasojejunal tubes, and those placed directly into the abdomen, such as a gastrostomy, gastrojejunostomy, or jejunostomy feeding tube .
Why are feeding tubes used in the ICU?
Feeding tubes are often used in the intensive care unit (ICU) to provide nutrition to people who are critically ill while their medical conditions are addressed; as of 2016 there was no consensus as to whether nasogastric or gastric tubes led to better outcomes.
Where is the nasojejunal tube?
A nasojejunal or NJ-tube is similar to an NG-tube except that it is threaded through the stomach and into the jejunum, the middle section of the small intestine. In some cases, a nasoduodenal or ND-tube may be placed into the duodenum, the first part of the small intestine. These types of tubes are used for individuals who are unable to tolerate feeding into the stomach, due to dysfunction of the stomach, impaired gastric motility, severe reflux or vomiting. These types of tubes must be placed in a hospital setting.
Where is the feeding tube inserted?
A jejunostomy feeding tube ( J-tube) is a tube surgically or endoscopically inserted through the abdomen and into the jejunum (the second part of the small intestine ).
Overview
A feeding tube is a medical device used to provide nutrition to people who cannot obtain nutrition by mouth, are unable to swallow safely, or need nutritional supplementation. The state of being fed by a feeding tube is called gavage, enteral feeding or tube feeding. Placement may be temporary for the treatment of acute conditions or lifelong in the case of chronic disabilities. A variety of feeding tubes are used in medical practice. They are usually made of polyurethane or …
Medical uses
There are dozens of conditions that may require tube feeding. The more common conditions that necessitate feeding tubes include prematurity, failure to thrive (or malnutrition), neurologic and neuromuscular disorders, inability to swallow, anatomical and post-surgical malformations of the mouth and esophagus, cancer, Sanfilippo syndrome, and digestive disorders.
Feeding tubes are used widely in children with excellent success for a wide variety of conditions. Some children …
Product types
Medical nutrition companies make flavored products for drinking and unflavored for tube feeding. These are regulated as medical foods, which are defined in section 5(b) of the Orphan Drug Act (21 U.S.C. 360ee (b) (3)) as "a food which is formulated to be consumed or administered enterally under the supervision of a physician and which is intended for the specific dietary management of a disease or condition for which distinctive nutritional requirements, based on recognized scientific principles, are established by medical evaluation."
Types
The most common types of tubes include those placed through the nose, including nasogastric, nasoduodenal, and nasojejunal tubes, and those placed directly into the abdomen, such as a gastrostomy, gastrojejunostomy, or jejunostomy feeding tube.
A nasogastric feeding tube or NG-tube is passed through the nares (nostril), down the esophagus and into the stomach. This type of feeding tube is generally used for short term feeding, usually less than a month, though so…
Complications
Nasogastric and nasojejeunal tubes are meant to convey liquid food to the stomach or intestines. When inserted incorrectly, the tip may rest in the respiratory system instead of the stomach or intestines; in this case, the liquid food will enter the lungs, resulting in pneumonia and can, in rare cases, lead to death.
Complications associated with gastrostomy tubes (inserted through the abdomen and into the stomach or intestines) include leakage of gastric contents (containing hydrochloric acid) around the tube into the abdomina…
Oral and dental complications
Guidelines for dental care for children fed by tube are poorly established. Many dental complications arise due to poor oral health that may result from reluctance or intolerance towards oral hygiene practices by patients and caregivers, abundance of dental plaque and/or tooth decay, and lack of oral simulation. Although many studies on this topic involve a relatively small sample size, the findings are important as they are associated with the development of various oral conditions, dental diseases and even systemic diseases such as aspiration pneumo…
See also
• Bioethics
• Force-feeding for tube feeding against an individual's will or as torture
• Nutrient enema
• Nasogastric tube
External links
• American Society for Parenteral and Enteral Nutrition