A feeding tube is a medical device used to provide nutrition to people who cannot obtain nutrition by mouth, are unable to swallow safely, or need nutritional supplementation. The state of being fed by a feeding tube is called gavage, enteral feeding or tube feeding. Placement may be temporary principles and practice of hospital medicine 2nd edition pdf the treatment of acute conditions or lifelong in the case of chronic disabilities.
A variety of feeding tubes are used in medical practice. There are dozens of conditions that may require tube feeding. Feeding tubes are used widely in children with excellent success for a wide variety of conditions. Some children use them temporarily until they are able to eat on their own, while other children require them longterm. Some children only use feeding tubes to supplement their oral diet, while others rely on them exclusively. People with advanced dementia who get feeding assistance rather than feeding tubes have better outcomes.
Feeding tubes do not increase life expectancy for such people, or protect them from aspiration pneumonia. 2016 there was no consensus as to whether nasogastric or gastric tubes led to better outcomes. As of 2017 it appeared that people with tube through the nose were able to start eating normally sooner. Medical nutrition companies make flavored products for drinking and unflavored for tube feeding.
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Nasogastric and nasojejeunal tubes are meant to convey liquid food to the stomach or intestines. Septic shock is another possible complication. A phenomenon called “tube dependency” has been discussed in the medical literature, in which a child refuses to eat after being on a feeding tube, but it is not recognized as a disorder in the ICD or DSM and its epidemiology is unknown. The most common types of tubes include those placed through the nose, including nasogastric, nasoduodenal, and nasojejunal tubes, and those placed directly into the abdomen, such as a gastrostomy, gastrojejunostomy, or jejunostomy feeding tube. This type of feeding tube is generally used for short term feeding, usually less than a month, though some infants and children may use an NG-tube longterm. Individuals who need tube feeding for a longer period of time are typically transitioned to a more permanent gastric feeding tube. A nasojejunal or NJ-tube is similar to an NG-tube except that it is threaded through the stomach and into the jejunum, the middle section of the small intestine.
In some cases, a nasoduodenal or ND-tube may be placed into the duodenum, the first part of the small intestine. These types of tubes are used for individuals who are unable to tolerate feeding into the stomach, due to dysfunction of the stomach, impaired gastric motility, severe reflux or vomiting. Gastric feeding tubes are suitable for long-term use, though they sometimes need to be replaced if used long term. A G-tube may instead be used for gastric drainage as a longer term solution to the condition where blockage in the proximal small intestine causes bile and acid to accumulate in the stomach, typically leading to periodic vomiting, or if the vagus nerve is damaged. Where such conditions are only short term, as in a hospital setting, a nasal tube connected to suction is usually used. A gastrojejunostomy or GJ feeding tube is a combination device that includes access to both the stomach and the jejunum, or middle part of the small intestine. Typical tubes are placed in a G-tube site or stoma, with a narrower long tube continuing through the stomach and into the small intestine.
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