Nutrition, Enteral

What is enteral nutrition?

Enteral nutrition, also called tube feeding, is a method of feeding liquid nutrition through a tube placed into your stomach or small intestine. You may need tube feeding if you are very malnourished. You may also need it if you are unable to swallow because of a medical condition, such as an injury to the face or neck, cancer of the mouth or throat, or a stroke. Some medical treatments may also make it hard for you to get enough nutrition, such as chemotherapy or radiation treatments for cancer.

Tube feedings are usually given through a gastrostomy tube (G-tube) placed directly into your stomach or small intestine through a small cut made in your belly. Temporary feeding tubes may also be used for tube feeding. The tube is put through your nose or mouth into your stomach or past the stomach into the small intestine.

How is enteral nutrition given?

Before tube feedings begin:

• Your healthcare provider will ask you to sign a consent form to place the feeding tube and begin feedings. The consent form will state the reason you are having the procedure, what happens during the procedure, and what you may expect afterward.
• Tell your healthcare provider if you have any food, medicine, or other allergies such as latex.
• Tell your healthcare provider if you are taking any medicines, including nonprescription drugs, herbal remedies, or recreational or illegal drugs.
• You will have a small tube (IV catheter) inserted into a vein in your hand or arm. This will allow for medicine to be given directly into your blood and to give you fluids, if needed.

During tube feeding placement:

• You may be given a sedative through your IV to help you to relax.

Nose or mouth tube placement:

• You will be given medicines to prevent pain during your procedure. Local anesthesia numbs the back of your throat and helps prevent gagging while the tube is being placed.
• 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. You may be asked to swallow as this happens.

Intestine tube placement:

• You will be given medicines to prevent pain during your procedure. These may include:
  • Regional anesthesia, which numbs a large area of your body. Depending on the medicine, you may be awake or asleep during the procedure.
• General anesthesia, which relaxes your muscles and puts you into a deep sleep. It also keeps you from remembering the operation. While you are asleep, you will have a tube in your throat to help you breath and to make sure you are getting enough oxygen. The tube may be removed before you wake up after the surgery.
• The surgeon will make a cut in the left side of the belly and a tube will be placed in the stomach and held in place by a small fluid-filled balloon or a plastic disc (cap) inside the stomach. In some cases, an endoscope, which uses a slim, flexible, lighted tube passed through your mouth to help place the tube in the correct position.

What happens after the feeding tube is placed?

• You will be checked often by nursing staff.
• You may have an X-ray of your belly to make sure that the end of the tube is in the correct place.
• If you had a G-tube placed, there will be a dressing on your G-tube site. The dressing will be checked and changed by your provider or the nursing staff as needed.
• Your healthcare provider may insert air into the tube and listen with a stethoscope to make sure the tube is in the correct place before starting feedings.
• You will be given a liquid formula through the tube into your stomach or small intestine. This may be given in larger amounts at regular times or it may be given in smaller amounts continuously.
• Your blood sugar may be checked regularly.
• Your blood oxygen level may be monitored by a sensor that is attached to your finger or earlobe.
• Your provider may prescribe medicine to:
  • Treat pain
  • Treat or prevent an infection
  • Treat other medical problems
  • Treat or prevent side effects, such as nausea
• Your provider may recommend other types of therapy to help relieve pain, other symptoms, or side effects of treatment.

What can I do to help?

• You will need to tell your healthcare team if:
  • The tube comes out
  • You have bleeding from your G-tube site
  • You have bright red blood in your vomit or vomit that looks like coffee grounds
  • Redness, swelling, pain, warmth, or drainage from your surgical wound
  • Fever, chills, or muscle aches
  • You have nausea or vomiting after feedings
  • You have bloating or belly pain
  • You have trouble breathing
  • You have frequent diarrhea
• Ask questions about any medicine or treatment or information that you do not understand.

How long will I be in the hospital?

How long you stay in the hospital depends on many things, such as your general health, other medical conditions you have, and the reason for your hospitalization. Talk with your provider about how long your stay may be.