How Does a Feeding Tube Work?

Caring for a loved one who has difficulty eating can be daunting, often requiring the use of feeding tubes to provide essential nutrients. Understanding how these tubes work and adequately caring for them is crucial for ensuring your loved one's health and well-being. This article will guide you through the different types of feeding tubes, their care, and the vital role of parenteral nutrition.

Tube feeding

People who require a feeding tube often include those with severe swallowing difficulties (dysphagia), neurological disorders (such as stroke or ALS), head or neck cancer, gastrointestinal disorders, or severe malnutrition. Feeding tubes provide essential nutrition when oral intake is inadequate or unsafe.

When someone has trouble eating regular food, healthcare providers use special tubes to deliver liquid nutrition directly into their stomach or small intestine. This liquid nutrition ensures that your loved one receives all the sustenance they need to stay strong and healthy. Tube feeding is a highly effective method for doctors to support individuals who cannot consume food normally.

Types of tube feeding

Understanding the different types of feeding tubes is essential for caregivers. Each type serves a specific purpose based on your loved one's medical needs. Here are the three main types you might encounter:

• Gastrostomy tube (G-tube): This soft tube goes through the belly wall into the stomach.
• Nasogastric tube (NG tube): This thin tube goes through the nose and down to the stomach.
• Jejunostomy tube (J-tube): This soft tube goes through the abdominal wall directly into the small intestine.

Doctors decide which tube is best based on your loved one's needs.

Gastrostomy tubes

Gastrostomy tubes (G-tubes) are inserted through the abdominal wall directly into the stomach, providing long-term nutritional support for individuals who cannot eat by mouth. Proper care includes keeping the tube and surrounding area clean to prevent infection and monitoring for any signs of irritation or complications.

Caring for G tubes:

• Comfort: Ensure the tube is taped securely but not too tight to avoid discomfort.
• Skincare: Protect the skin around the nose and mouth to prevent irritation, applying the cream as directed.
• Cleaning: Keep the tube clean by following healthcare provider instructions to avoid infections.

Nasogastric tubes

Nasogastric tubes (NG tubes) are temporary feeding tubes inserted through the nose and down into the stomach. They are typically used for short-term nutritional support when a patient cannot eat by mouth. Proper care includes securing the tube to prevent discomfort and maintaining cleanliness to avoid infection.

Caring for NG tubes:

• Comfort: Make sure the tube is taped securely but not too tight.
• Skincare: Protect the nose and mouth to prevent irritation. Apply cream as directed.
• Cleaning: Keep the tube clean to prevent infections. Follow your healthcare provider's instructions.

Jejunostomy Tubes

Jejunostomy tubes (J-tubes) are inserted through the abdominal wall directly into the small intestine, often used when the stomach cannot process food properly. They require diligent care to keep the surrounding area clean and dry to prevent infection. Caregivers should monitor for any discomfort or complications and follow healthcare provider instructions closely.

Caring for J-tubes:

• Cleaning: Keep the tube clean to prevent infections. Follow your doctor's instructions.
• Skincare: Protect the skin around the tube to avoid irritation. Apply cream as directed.
• Feeding schedule: Feed your loved one a set schedule using a feeding pump.

Feeding your loved one

Food given through a feeding tube is typically liquid food formulas (eternal nutrition) specifically designed to provide all the necessary nutrients. These formulas can be categorized as follows:

1. Standard formulas: These are balanced and complete, providing proteins, carbohydrates, fats, vitamins, and minerals to meet general nutritional needs.
2. Specialized formulas: These are tailored to specific medical conditions or dietary requirements, such as:
   • High-protein formulas for individuals needing extra protein for healing or muscle maintenance.
   • Low-residue formulas for those who need easily digestible nutrients with minimal fiber.
   • Diabetic formulas designed to manage blood sugar levels.
   • Renal formulas for individuals with kidney disease are often lower in certain minerals like potassium and phosphorus.
3. Elemental formulas: These contain nutrients in their simplest form (amino acids, simple sugars) for easier digestion and absorption; they are often used for patients with severe digestive issues.
4. Blenderized formulas: These can be commercially prepared or homemade and consist of blended whole foods that meet nutritional needs. They must be carefully prepared and strained to avoid clogging the tube.

Can you still eat regular food with a feeding tube?

Whether someone can eat regular food while having a feeding tube depends on their medical condition and doctor's recommendations. In some cases, individuals with feeding tubes can still consume food by mouth, supplementing their nutrition as needed. However, others might need to rely entirely on the feeding tube if they have severe swallowing difficulties or other conditions that prevent safe eating. Follow the guidance of healthcare providers to ensure safe and appropriate nutrition.

Scheduling

• Feeding schedule: Stick to the feeding schedule provided by your loved one's healthcare provider. This typically includes specific times and amounts for each feeding to ensure the patient receives adequate nutrition without overloading their digestive system.
• Feeding methods:
  • Continuous feeding: Delivered slowly over several hours using a feeding pump, suitable for patients who cannot tolerate large volumes at once.
  • Intermittent or bolus feeding: Larger amounts given at regular intervals throughout the day, simulating normal meal times.

Administration

• Using a feeding pump: Always use a feeding pump to deliver the formula through a feeding tube accurately, regulating the flow rate and ensuring consistent delivery of nutrients.
• Monitoring: Keep a close eye on the person receiving the feeds and watch out for any signs of feeding problems. These may include bloating, vomiting, or diarrhea. Be vigilant and report any issues to the doctor or healthcare professional.
• Tube placement: Regularly check for proper tube placement with the assistance of the care team to prevent complications such as aspiration or dislodgment.

How long can someone live with a feeding tube?

The length of time someone can live with a feeding tube varies greatly depending on their underlying medical condition and overall health. Some individuals may need a feeding tube temporarily and can return to normal eating once they recover. Others, especially those with chronic or severe conditions, may rely on a feeding tube for many years. With proper care and management, a person can live a long and fulfilling life with a feeding tube.

Unclogging a feeding tube

To unclog a feeding tube, follow these steps:

1. Flush with warm water: Use a syringe to flush warm water into the tube gently. This can help dissolve the clog. Repeat as necessary.
2. Use a gentle pumping motion: While flushing with water, use a gentle back-and-forth pumping motion with the syringe to dislodge the clog.
3. Commercial declogging kits: If water alone doesn't work, use a commercial declogging kit specifically designed for feeding tubes, following the manufacturer's instructions.
4. Enzymatic declogging solution: Your healthcare provider might recommend using an enzymatic declogging solution. Inject the solution into the tube and let it sit for the recommended time before flushing again with water.
5. Seek professional help: If the tube remains clogged after trying these methods, contact your healthcare provider for assistance.

Notes: Due to the tube's placement through the nose, N-tubes should be extra gentle to avoid discomfort or dislodging the tube. For J-tubes, given their placement in the small intestine, follow your loved one's doctor's medical advice precisely to avoid complications.

Removing a feeding tube

When a feeding tube is removed, the site where it was inserted is carefully monitored to ensure it heals properly. In most cases, the small opening will gradually close on its own. However, if the tube has been in place for a long time, the healing process might take longer, and medical intervention could be needed to close the site. Patients transitioning off tube feeding will typically need to gradually reintroduce oral feeding under medical supervision to ensure they can safely and effectively resume eating normally.

Managing tube feeding

Follow your healthcare provider's instructions for tube feeding and care. If you have any questions or worries, talk to your loved one's physician. When taken care of properly, tube feeding can help your loved one get the nutrition they need. It can be challenging to take care of a loved one who needs tube feeding or parenteral nutrition, but there are many resources to help you on this journey.