Patient education: Enteral (tube) feeding (The Basics)

What is enteral feeding? — Enteral feeding is a way to get food and nutrients when a person cannot get enough nutrition from eating or drinking by mouth. With enteral feeding, the person gets liquid food or formula through a flexible plastic tube. This liquid food has all of the nutrients the body needs. The tube can also be used to give medicines.

Enteral feeding is also called "tube feeding."

Why might I need a feeding tube? — Your doctor will put in a feeding tube if you cannot get enough nutrition from eating and drinking by mouth. For example, this might be because you are too sick to eat enough, you cannot eat for some time after a surgery, or you have trouble with swallowing that is not getting better.

There are different types of feeding tubes. The type of tube you get depends on how long you will need it. Your doctor will also consider other problems you might have digesting food.

Types of feeding tubes include:

●Nasogastric ("NG") tube (figure 1) – This is usually for people who only need help getting food and nutrients for a few weeks or less. It is inserted through 1 of the nostrils and guided down into the stomach. In some cases, the tube goes beyond the stomach and into the intestine. When this happens, it is called an "NJ" tube.

●Gastrostomy ("G") tube (figure 2) – This is usually for people who need help getting food and nutrients for a longer amount of time. Usually, this means 4 weeks or longer.

•A G tube is inserted through the skin of the belly and guided into the stomach during a surgery. In some cases, the tube extends into the small intestine. When this happens, it is called a "GJ" tube.

•Often, the doctor will use a special tool called an "endoscope" to help them place the tube. Tubes that are put in this way are called "percutaneous endoscopic gastrostomy" ("PEG") tubes.

•After a G tube is placed, some tubing sticks out of the belly. This part is usually about 6 to 12 inches (15 to 30 cm) long.

•Some people get something called a "G button." With a G button, there is no long tubing sticking out of the body. Instead, you have a "button" that is mostly flat against your skin. When you need to feed yourself though a G button, you connect extra tubing to the button opening.

●Jejunostomy ("J") tube – This goes through the skin of the belly, similar to a G tube. But instead of going into the stomach, it goes directly into part of the small intestine called the "jejunum." J tubes are used less often than G tubes.

The end of the feeding tube on the outside of your body has a small cap that you take off to feed yourself. With a feeding tube, you are able to get all of the nutrients your body needs. This can help your body heal and recover faster. Your doctor or nurse might also use the tube to give you medicines.

How is a feeding tube put in? — It depends on the type of tube.

NG tube:

●To put in an NG tube, your doctor or nurse might give you a nose spray to numb your nose. Then, they will slide the tube in through 1 of your nostrils. As the tube goes in, you will need to swallow. It can help to take small sips of water.

●Once the tube is in, it is taped into place on your face. You will get an X-ray to check that the tube is in the right place before it is used for feeding. An X-ray is an imaging test that creates pictures of the inside of your body.

●An NG tube can be put in at a doctor's office or hospital. You will probably be awake while the tube is put in place. You might be a little uncomfortable during the procedure, but it shouldn't be painful and doesn't take long.

G tube:

●G tubes are put in place through surgery. This involves making a cut in the belly to place the tube into the stomach.

●In some cases, the surgeon will use a special tool called an "endoscope" to do the surgery. This is a thin, flexible tube that goes in through your mouth and down to your stomach. It has a light and a camera so the doctor can see inside your body. This lets them put the feeding tube in place through a smaller cut in the skin. Once the feeding tube is in place, the endoscope is removed.

J tube:

●J tubes are usually put in place through surgery.

How do I take care of the tube after it is put in? — If you are going home after your tube is put in, your doctor or nurse will talk to you about how to take care of it, and how and when to feed yourself.

What problems can happen with feeding tubes? — Most of the time, your feeding tube should work fine. But sometimes, things can go wrong.

Call your doctor if:

●You have problems with your tube – Call your doctor right away if your tube gets clogged, it comes out, or you notice leaking from the tube.

●You have signs of wound infection (if you got a G tube) – Call your doctor if you have a fever of 100.4°F (38°C) or higher. You should also call if the place where the tube enters your body is red or swollen, feels warm to the touch, has discharge or pus, smells bad, is very painful when touched, bleeds, or doesn't seem to be healing.

●You cannot have a bowel movement or pass gas, or you have stools that are loose or hard.

●You have pain or cramping in your stomach.

●You vomit.

What else should I know? — Follow all of your doctor's or nurse's instructions about how to feed yourself, what to feed, and how often.

How will the feeding tube be removed? — It depends on the type of tube you got and how long you need it for. Talk to your doctor or nurse about how long you will need a feeding tube. They will tell you when and how it can be removed.

Some people need to have a G tube permanently. If that is the case, you will sometimes need to have your G tube replaced. Your doctor will do surgery to take out your old tube and put in a new one. This happens at least every 6 to 8 months.

More on this topic

Patient education: How to care for a G tube or G button (The Basics)
Patient education: Advance directives (The Basics)
Patient education: Medical care during advanced illness (The Basics)
Patient education: What to expect in the NICU (The Basics)
Patient education: Surgical gastrostomy (The Basics)
Patient education: Parenteral nutrition (The Basics)
Patient education: How to care for a nasogastric tube (The Basics)
Patient education: How to put in a child's nasogastric tube (The Basics)
Patient education: How to give a tube feeding (The Basics)
Patient education: Percutaneous endoscopic gastrostomy (PEG) in adults (The Basics)