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.
How long does it take for a feeding tube to heal?
With the longer-term tubes, like G-tubes and J-tubes, patients may experience some initial pain and discomfort, but it should fade after a day or two. How do feeding tubes work? Different tubes work in different ways.
Can a feeding tube be discontinued to prolong life?
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.
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.
When was the first feeding tube used?
The first recorded occasion was by Capivacceus in 1598 who used the tube to provide nutrients to the foregut [1]. During the seventeenth century, it became more common to feed liquid nutrients fed by a tube in the oesophagus [1] .
How long can a person live on a feeding tube?
A feeding tube can remain in place as long as you need it. Some people stay on one for life.
What is the difference between NG tube and feeding tube?
Types of Feeding Tubes Gastrostomy tubes, also called G-tubes or PEG tubes, are short tubes that go through the abdominal wall straight into the stomach. Nasogastric tubes, or NG tubes, are thin, flexible tubes inserted through the nose that travel down the esophagus into the stomach.
What is the medical term for feeding tube?
It allows air and fluid to leave the stomach and can be used to give drugs and liquids, including liquid food, to the patient. Giving food through a PEG tube is a type of enteral nutrition. Also called gastrostomy tube and percutaneous endoscopic tube.
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.
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.
Which is better NG tube or G tube?
While NG tubes are easier to place, tube removal is common and proper positioning is essential to prevent potential respiratory complications. Alternatively, G-tubes may be more stable but require an invasive procedure with risks for major and minor procedural and anesthetic complications, infection, and wound issues.
Why is PEG tube better than NG tube?
Conclusion: PEG is a better choice than NGT feeding due to the decrease in risk of pneumonia requiring hospital admission, particularly in patients with abnormal amounts of pooling secretions accumulation in the pyriform sinus or leak into the laryngeal vestibule.
What is the most common problem in tube feeding?
Diarrhea. The most common reported complication of tube feeding is diarrhea, defined as stool weight > 200 mL per 24 hours.
Who invented feeding tubes?
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.
What are the dangers of a feeding tube?
Complications Associated with Feeding TubeConstipation.Dehydration.Diarrhea.Skin Issues (around the site of your tube)Unintentional tears in your intestines (perforation)Infection in your abdomen (peritonitis)Problems with the feeding tube such as blockages (obstruction) and involuntary movement (displacement)
Why do adults have feeding tubes?
Feeding tubes are used to make sure that someone who is unable to swallow can still get needed nutrients, fluids, and medication. The need for the tube might be temporary, or it may be related to a chronic condition like stroke or cancer. The kind of tube will depend on the condition and how long it's needed.
What happens if you remove a feeding tube?
Removal of the tube or cessation of feeding would lead to death from dehydration or starvation. If the tube were to fall out, the mother would be able to insert it within the first few hours (before the stoma starts to close).
Why do people die from removing their feeding tube?
We hold that removing the feeding tube is the proximate cause of death from dehydration or starvation. If insertion of the tube is regarded as medical treatment and tube feeding as ordinary care, the ethical issues surrounding tube withdrawal and the cessation of feeding become clearer.
What is the decision to insert a PEG feeding tube?
The decision to insert a PEG feeding tube should follow a clear discussion with the patient and/or carers. The procedure itself carries risks that ought to be balanced against the benefits that may accrue for the well-being of the patient.
What is consent to feeding via the tube?
Consent to feeding via the tube is implicit in the initial agreement to tube placement. Where the tube is deliberately removed or feeding stopped in the knowledge that the patient is unable to swallow, the action amounts to causing death through starvation and could constitute criminal negligence.
Why is anaesthesia necessary for tube placement?
A general anaesthetic was deemed necessary for tube placement because of her marked skeletal deformity and to control her airway during the procedure. It was also felt that the patient would not tolerate the procedure under sedation. There was an estimated.30% - 40% risk of dying from the anaesthetic.
Is tube feeding legal?
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. Despite this, doctors have misgivings about the removal of feeding tubes and feel that cessation of tube feeding can be a direct cause of death. We argue that feeding tube placement is a medical procedure and as such requires consideration of the benefits and risks as for any other medical treatment. However, the day-to-day use of feeding tubes, to provide hydration and nutrition, constitutes ordinary care that does not require medical supervision. Withdrawal of tube feeding raises major ethical and legal questions, as it removes a simple channel for the provision of nutrition. With rare exceptions, cessation of tube feeding is done with the intention of causing death through dehydration or starvation.
Is there a reason to withdraw feeding?
There now exists a simple means of providing life-sustaining nutrition without due risk or burden to the patient. There is usually no reason to withdraw feeding other than to cause the death of the patient. Consent to feeding via the tube is implicit in the initial agreement to tube placement.
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.
Is it easy to feed a patient with a feeding tube?
Feeding tubes are relatively easy. It is at times very difficult and time consuming to hand-feed a patient who is able to swallow but unable to feed herself. A feeding tube may be an easy way out, but this is not acceptable.
Can a feeding tube be inserted through the nose?
If the feeding tube is inserted through the nose, there is a high incidence of aspiration where stomach contents regurgitate up and are sucked into the lungs. The incidence is less, though not absent, when a gastric tube is inserted directly through the abdomen into the stomach.
Can you tube feed someone who has a stroke?
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.
When did the supplemental enteral nutrition 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. Early procedures were generally disastrous, however, techniques rapidly improved. The basic techniques of surgical enteral access have not changed significantly in ...
Has surgical enteral access changed?
The basic techniques of surgical enteral access have not changed significantly in the last century, although endoscopic, radiologic and laparoscopic modifications have been described and adopted in the last 25 years.
How long does it take for a person to stop eating after a feeding tube?
If the person is totally unable to eat and does not use a feeding tube, the body will slowly shut down over a period of one to two weeks. Comfort measures are given, so the patient does not suffer, and hospice care can help the patient and family.
What is NG tube?
Patients may be fed during hospitalization with an NG Tube (naso-gastric tube, inserted through the nose and down the esophagus to the stomach ), which allows the patient to receive liquid nutrition. If swallowing difficulties continue, physicians may discuss the use of a G-tube (gastric tube) with the family.
Can you pull out a tube with dementia?
Some patients truly miss the taste and experience of eating and find normal eating hard to give up. Patients with dementia and/or severe agitation may pull at the tube and/or pull it out, which might require sedation or restraints. And remaining sedentary for the time required to receive the feedings may be difficult.
Can you use a feeding tube in hospice?
Depending on the situation, people receiving tube feedings may not be able to avail themselves of hospice services. If the family chooses not to insert a feeding tube, the patient and family may have decided that this person is in the final stages of the illness, and that they are now willing to allow death to occur.
Can you live with Alzheimer's with feeding tubes?
There is some debate, for example, about whether feeding tubes actually extend life in end-stage Alzheimer’s disease. For many, this is a quality of life issue, and they would prefer to not to live this way.
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 ...
How long does a NG tube last?
It can remain in place for four to six weeks before it must be removed or replaced with a long-term feeding tube. 4
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 it take to remove a feeding tube?
It is then gently pulled out, taking three to five seconds to steadily be removed. If the tip of the tube is intact, demonstrating that the entire tube has been successfully removed, it is thrown away.
Why is it so difficult to place a feeding tube?
The decision to place a feeding tube is a complicated one and is made more difficult if the patient is not able to participate in the discussion or hasn't yet shared their wishes regarding their health care.
What is the purpose of a feeding tube for cancer patients?
When cancer patients struggle with this, a feeding tube can be a solution. These flexible plastic tubes placed in the stomach can help provide the calories, protein, vitamins, minerals and fluids needed to help the body fight infection, ...
Why do cancer patients need feeding tubes?
Cancer patients may need a feeding tube if they: Have trouble swallowing due to cancer in the head or neck area. Are malnourished before or during cancer treatment, including surgery, chemotherapy and radiation therapy. Have fistulas, an opening, or an abscess in the esophagus or stomach.
What is a tube for food?
The tube delivers food and medicine until the person is healthy enough to eat by mouth. It bypasses the stomach completely and is often used when the patient cannot digest food in the stomach, like in some cases of stomach cancer. This tube is also best-suited for long-term use.
Where is the feeding tube placed?
It is placed at the patient’s bedside in the hospital and doesn’t require a surgical procedure.
How long does it take for a NG tube to feel?
Again, this depends on the type of tube. Patients typically can feel an NG-tube, but the good news is, it’s only used for a few days or weeks. With the longer-term tubes, like G-tubes and J-tubes, patients may experience some initial pain and discomfort, but it should fade after a day or two.
Can you hide a feeding tube under clothes?
Feeding tubes are very easy to hide under clothes. Many of our patients go back to work after having a feeding tube installed, and their co-workers have no idea they have a feeding tube. With closer family and friends, we recommend educating them about your condition and showing them how the feeding tube works.
Can you use feeding tubes at MD Anderson?
Yes, all three types of the common feeding tubes mentioned above can be operated by the patients themselves. But depending on their physical and mental health, they may need help from a caregiver or health care provider. At MD Anderson, we provide classes for patients and caregivers to prepare them to use feeding tubes.