Feeding tube
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A feeding tube is a medical device used to provide nutrition to patients who cannot do so via the normal oral route. Placement may be temporary for the treatment of acute conditions or lifelong in the case of chronic disabilaties. Many patients treated using a feeding tube lack the ability to survive on their own without such technology. A variety of feeding tubes are used in medical practice. They are usually made of polyurethane or silicone. The diameter of a feeding tube is measured in French units (each French unit equals 0.33 millimeters). They are classified by site of insertion and intended use.
Nasogastric tube
A nasogastric tube (NG tube) is a tube, inserted into a nostril of the nose, into the throat, down the esophagus and into the stomach. It is suitable only for relatively short-term use, as it is uncomfortable and tends to be removed by the patient. It is used for nasogastric suction (for intestinal decompression), and for administration of medications to those unable to swallow. A slightly more flexible and thinner version, a nasogastric feeding tube, is used for enteral feedings and hydration in patients who either cannot eat, or who have swallowing difficulties that would result in pneumonia if they were permitted to attempt to eat.
Esophagostomy tube
The esophagostomy tube is inserted through the side of the neck into the esophagus and threaded into the stomach. It is rarely used in humans, but is commonly used in veterinary practice to feed animals with jaw injuries which prevent chewing.
Gastric feeding tube
A gastric feeding tube, or "G-tube", is a tube inserted through a small incision in the abdomen into the stomach and is used for long-term enteral nutrition. The most common type is the percutaneous endoscopic gastrostomy (PEG) tube. It is placed endoscopically: the patient is sedated, and an endoscope is passed through the mouth and esophagus into the stomach. The position of the endoscope can be visualized on the outside of the patient's abdomen because it contains a powerful light source. A needle is inserted through the abdomen, visualized within the stomach by the endoscope, and a suture passed through the needle is grasped by the endoscope and pulled up through the esophagus. The suture is then tied to the PEG tube, and pulled back down through the esophagus, stomach, and abdominal wall. The insertion takes about 20 minutes. The tube is also occasionally placed surgically. After the insertion, the abdominal wound must covered with sterile dressings until it is healed (about a week). The tube is kept within the stomach by a balloon on its tip (which can be deflated to remove the tube). Gastric tubes are suitable for long-term use: they last about six months, and can be replaced through an existing passage without an additional endoscopic procedure. The G-tube is useful where there is difficulty with swallowing because of neurologic or anatomic disorders (stroke, esophageal atresia, tracheoesophageal fistula), and to avoid the risk of aspiration pneumonia. It is also used when patients are malnourished and cannot take enough food by mouth to maintain their weight.
Jejunostomy tube
A jejunostomy tube is similar to a gastric tube, though generally has a finer bore and smaller diameter, and is surgically inserted into the jejunum rather than the stomach. They are used when the upper gastrointestinal tract must be bypassed completely, and can be used as soon as 12 hours after surgery.
Feeding through these tubes are generally commercially prepared to provide adequate nutrition and to not result in clogging when used with a pump or with drip feedings.
Withdrawal
Tube feeding, like all medical treatments, can be declined or withdrawn, especially in the setting of a terminal illness where its use would not alter the ultimate outcome. This is considered by some to be a form of euthanasia.
See also
External links
- Handbook for Mortals on issues of tube feeding patients with terminal diseases (http://www.mywhatever.com/cifwriter/library/mortals/mor11101.html)de:Magensonde