Gastrostomy tube feeding
Tube feeding allows people who have problems taking food and fluid orally to maintain their nutritional needs.
What is tube feeding?
Tube feeding or a gastrostomy tube is a tube that is placed directly into the stomach or small intestine.
Instead of taking oral foods, liquid nutrition is given via a tube straight into the gastrointestinal system. Tube feeding can be temporary or permanent.
Common indications for tube feeding
People who require tube feeding generally have a neurological illness that affects their ability to swallow correctly.
Common indications for tube feeding include:
- Problems swallowing related to a neurological condition (advanced dementia, stroke, Parkinson's disease)
- Obstruction between mouth and stomach related to cancer or surgery
- Inability to consume sufficient calories for nutritional needs
- Decreased consciousness
In some cases the decision to start tube feeding for people living with advanced chronic disease such as dementia can be difficult and emotional.
Patients and families should be careful to consult a number of health care professionals about the potential benefits and risks associated with tube feeding.
Insertion of a gastrostomy tube
Insertion of a gastrostomy tube is a simple surgical procedure that can be done under sedation.
A small tube or catheter with a balloon or special tip on the end is inserted through a small cut in the stomach. The tube enters through the skin into the stomach wall, directly into the stomach.
A jejunostomy tube is inserted into the small bowel for people at risk of aspiration.
The wound is sutured around the tube and heals in about a week. The tube has a seperate portal for liquid nutrition and one for medication.
Nutrition and tube feeding regimes
Before a feeding regime is determined an individual will be assessed by a dietician.
Liquid nutrition is introduced slowly. There are a variety of feeding formulas available. A dietician will choose the best formula for an individual based on their nutritional requirements and health status.
Feeding formulas are given via bolus feed, gravity control or a pump feed machine.
A nurse will work with a person and their carer to ensure they know how to correctly manage and care for a gastrostomy tube. Other people may need specialised nursing care or assistance.
Tube feeding regimes may change over time according to an individual's nutritional needs, lifestyle and reaction to the feed.
Side effects of tube feeding can include diarrhoea, constipation and tube blockage. Medications and water can also be administered via the tube feed.
Care of a gastrostomy tube and giving enteral feeds takes special skill. Many older people successfully manage their own tube feeds and learn to adjust to the changes tube feeding can bring.
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