FAQs on Feeding Tubes and Endoscopy

Q- What Is Feeding Tubes?

Ans- Feeding Tubes

A feeding tube is a medical device used to provide nutrition to patients who cannot obtain nutrition

 by swallowing. 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.

Types of feeding tubes:

• NASOGASTRIC TUBE: NG-tube is passed through the nostril down the oesophagus and into
•  the stomach. This type of feeding tube is generally used for short term feeding, usually only 2
•  weeks maximum.
• GASTRIC FEEDING TUBE: A gastric feeding tube (G-tube or "button") is a tube inserted
• through a small incision in the abdomen into the stomach and is used for long-term eternal
• nutrition. One type is the Percutaneous endoscopic gastrostomy (PEG) tube which is placed
• endoscopically. The position of the endoscope can be visualized on the outside of the patient's
• abdomen because it contains a powerful light source. These tubes are suitable for long-term
• use, though they sometimes need to be replaced if used long term. The G-tube can be
• useful where there is difficulty with swallowing because of neurologic or anatomic disorders 
• and to avoid the risk of aspiration.
• JEJUNOSTOMY FEEDING TUBE: or J-tube is a tube surgically inserted through the abdomen
• and into the jejunum i.e. the second part of the small intestine.

Complications of feeding tubes

Gastric feeding tubes have a variety of complications that can occur, though the overall rate

 of complication is about 1%. As gastric feeding tubes are placed as part of a procedure

 that punches a hole in the stomach and skin, this can lead to leaking of contents into the abdomen.

The most frequent complication is irritation around the site of the insertion, generally caused 

by stomach acid and feedings leaking around the site. Barrier creams, dressings, and frequent

 cleaning is generally recommended.

Especially in advanced dementia, patients can pull at the feeding tubes causing them to be

 dislodged and requiring a hospitalization to replace them.

Feeding tubes may become clogged or occluded if not flushed with water after each feeding.

 A clogged tube may need to be replaced.

Nasogastric feeding tubes, if inserted incorrectly, can cause collapsed lungs .

Withdrawal of tubes

Tube feeding, like all medical treatments, can be declined or stopped, especially in the

setting of a terminal illness where its use would not alter the ultimate outcome. Alternatively,

nutrition can be withheld and the tube used only for hydration and medicine if desired.

Some patients or families will opt for a "time limited trial" of feeding through a tube, but after

a set time period if the individual is not improving feedings are stopped and the goals of care

are refocused to comfort measures

Stomach tubes

Many critically ill patients are not able to swallow properly. Also, patients on mechanical ventilators

cannot eat by mouth. When the stomach and intestines continue to work, a tube is placed

through the nose or mouth and pushed down into the stomach. This tube allows nurses to

make sure that the stomach does not get over filled, and also to feed the patient.

Nasogastric (or "N.G.") tubes are thicker tubes (about the thickness of a pencil).

These tubes are used when it is important both to suck out stomach fluid for testing,

to prevent over filling, and for feeding. Feeding tubes are thinner tubes that are used mainly

 for feeding.

Common reasons for its use and benefits:

• MONITORING THE STOMACH - This is very important to prevent the stomach from
• being overfilled with food or stomach juice, and to make sure the stomach juice does
• not become too acid.
• FEEDING - Some patients who cannot swallow and some patients who are on mechanical 
• ventilators can be fed through nasogastric or feeding tubes.

Risks:

Some of the risks of putting in a nasogastric or feeding tube include:

• DISCOMFORT DURING PLACEMENT - Discomfort can result when the tube is inserted.
•  Doctors try to lessen the pain by putting a jelly on the tube that helps it to slide in more smoothly.
• While the tube is being passed, it can go down the windpipe instead of into the stomach.
•  This can cause coughing. Doctors often get an x-ray to see where the tube goes before
•  they give food or water through it.
• COLLAPSED LUNG - While the tube is being passed, it may, very rarely, go down into the
•  wind pipe and puncture the lung. This hole may seal quickly on its own. If the hole does not
•  seal over, air can build around the lung and cause it to collapse (this is called pneumothorax).
•  In such cases, a chest tube is sometimes needed to drain air from around the lung.

Because of the low risk and common need for stomach tubes, the consent that patients sign for

general treatments at the time of coming into the hospital usually includes permission for

passing a stomach tube through the nose or mouth if it is needed. If the tube is needed for a 

long time, doctors may need to make a hole in the abdomen and pass a tube through the skin,

into the stomach or intestines. Surgery of this nature requires consent from patients or families.

Please Note: The information contained in this leaflet is designed to provide some basic information

regarding surgery. This information is in no way intended to supersede the recommendations

given to you by your medical caregivers. If you have a question about your medical condition,

or if at any time you feel you need the advice or treatment of a physician, you should seek it

immediately.