Enteral Feeding

Enteral feeding

Oral — Patients who can eat normally.
Nasogastric — Best for short-term nutritional supplementation.
Naso-enteric route is used if there is impaired gastric emptying or jejunal feeding is required, e.g pancreatitis.
- It can be established at laparotomy, endoscopically or radiologically.
- There are an increasing number of well-designed nasojejunal tubes for endoscopic placement, both single lumen and double lumen for simultaneous gastric drainage and Jejunal feeding.

Percutaneous endoscopic gastrostomy (PEG) —It is achieved by incising over the illuminated tip of the endoscope while it is in the stomach and then “railroading a feeding tube” through the gastric and abdominal puncture hole. Indications: Mostly ‘neurological diseases’, e.g., stroke, motor neuron disease bulbar palsy & head injury etc.

Contraindication: — Complete esophageal obstruction.

Complications: are few (3%) but may be serious, e.g. sepsis or perforation of another viscus, e.g. colon.
Feeding jejunostomy—Placement of the feeding tube is done at laparotomy when oral intake is not likely for seven or more days, e.g. - a- Major upper GI resections like esophagectomy, gastrectomy, pancreatoduodenectomy. - b- Major abdominal trauma or when having postoperative chemotherapy or radiotherapy.

Mechanical: tracheobronchial intubation, erosion, blockage, displacement, bowel perforation
Metabolic: Fluid/ electrolyte imbalance, hyperglycemia, Refeeding / overfeeding syndromes
Gastrointestinal: Diarrhea, vomiting, pain
Pulmonary: Aspiration
Infection: Tube site