Enteral Nutrition

Enteral nutrition refers to feeding directly into the stomach and/or small bowel. During a surgical procedure, a feeding tube is placed into the small bowel or stomach providing a direct way for a patient to receive nutrients when he/she cannot eat orally.

The type of nutrition used in enteral feedings is similar to Ensure or Boost. It comes in many different versions and from many different companies. The most common ones are Jevity, Ultracal, Nutren, Vivonex, and Peptamin, although there are many others. Most are available in 1.0, 1.2, 1.5 and 2.0. The difference between the numbers depends on calories and thickness. The higher the number is the more calories it contains, but it also increases in thickness. Most people with motility disorders use 1.0-1.5 because the thicker ones are more difficult to digest. The lower number of calories per 8 oz may require a longer time period hooked up to the feeding pump in order to get the required number of nutrients. In addition, some formulas contain fiber, while others don't. It is often necessary to try a couple of versions in order to determine the needs and tolerance of each individual patient.

Tube feedings may be used for people who cannot eat at all, or for people who cannot each as much as necessary and just need some supplementation. The amount of feeding the patient receives may change based on how well he/she is eating. Often, with time as the body regains nutritional status and strength, the stomach is more able to tolerate food and tube feedings can decrease or stop completely. In many instances, feeding tubes are able to be pulled out because they are no longer needed.

There are several types of feeding tubes. J-tubes are impanted surgically into the small bowel, while g-tubes are placed into the stomach. In some instances people have both. The g-tube is used for decompressing the stomach and j-tube for feedings. Occasionally, usually for short-term purposes, an NG/NJ tube is placed. These tubes are inserted through the nose and into the stomach or jejunum. While it prevents a surgical procedure, it can also be uncomfortable. Liquid medications and crushed pills can be taken through feeding tubes to enhance absorption and effectiveness.

Typically feeding tubes are best in people who have upper GI issues and limited problems with the small bowel. They are a much safer alternative than parenteral nutrition

More information on j/g-tube placement