Feeding tube types and uses

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A feeding tube is a medical device used to feed a person who cannot safely take food by mouth. This difficulty can be due to difficulty swallowing , altered levels of consciousness, an eating disorder, or other problems that make eating difficult.

There are several types of feeding tubes and many reasons why you might need them. Every situation is different, and deciding to permanently install the feeding tube is a different matter than putting the temporary tube back in place.

To make an informed decision about feeding tubes, you need to understand what a feeding tube is, the differences between the types of feeding tubes when a feeding tube is needed and optional, and how these tubes are installed.

What is a feeding tube?

A feeding tube is a plastic tube used to prevent a patient from chewing and swallowing when they cannot safely eat or drink. These tubes can be used to administer food and liquids, and they can also be used to administer medications as needed. A feeding tube can also be used to remove fluid from the stomach if the body does not handle stomach contents well.

Applications

Feeding tubes are not only useful for feeding, but they can also reduce gas and bloating, as well as nausea and vomiting.

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Usually a feeding tube is used:

  • Nutritional support : Food in liquid form can be fed through a feeding tube. Tube feeding or enteral feeding can be given by tube to provide the body with carbohydrates, proteins, and fats without the need for the patient to swallow or chew.
  • Liquid supply : Water can be delivered through a feeding tube to keep the patient hydrated without the need for intravenous fluids .
  • Medication delivery : Medications, including many pills and tablets, can be given through a feeding tube. The tablets may need to be crushed and some capsules open, but if the particles are small enough, most medications can be mixed with water and given through a feeding tube.
  • Stomach decompression : Some types of feeding tubes can be used to remove air from the stomach. Some types of feeding tubes, particularly temporary ones, can be attached to a suction device to gently remove gas from the stomach and reduce bloating and bloating .
  • Elimination of stomach contents : If you do not handle food or liquids, there may be food in your stomach that causes discomfort, nausea, vomiting, or abdominal pain and bloating. Gentle suction can be used to remove liquids and small food particles from the stomach.

Indications

A feeding tube is necessary if you cannot safely take food or fluids by mouth. Although fluids and food can be given intravenously , the body is better at delivering food to the intestines than to the blood vessels.

It is safer and better for the body to get food and fluids into the stomach if possible for normal digestion, but if you have difficulty swallowing it may not be safe.

Swallowing problems can mean that the patient has choked on food and fluids or has 'gone down the wrong tube' and that something is being inhaled into the lungs instead of being swallowed. This can lead to serious illnesses, including pneumonia , from food particles entering the lungs.

Others may be too sick to swallow or are hooked up to a ventilator with a tube inserted into the airway that prevents swallowing. Some patients are alert and focused, but have lost the ability to swallow well. However, others have a disease or condition that makes swallowing difficult, such as oral cancer .

The decision to put a feeding tube.

The decision to place a feeding tube is difficult and complicated if the patient cannot participate in the discussion or has not yet shared their health wishes. In many cases, a patient who needs a feeding tube is sedated or unconscious and cannot share his wishes with friends and family.

The question of what the patient wants and whether the tube will be temporary, long-term, or permanent requires consideration. Some families spend their days discussing the decision with each other, or they may have a family meeting with the medical staff to discuss the decision.

In many cases, the decision to place a feeding tube is related to the decision to place a tracheostomy, an opening in the throat through which a ventilator can help you breathe.

This is because intubation , the process by which a tube is inserted into the mouth and lowered into the airway so that a ventilator can be used, can only be used for a few weeks until the throat is damaged.

Since both actions are performed within a two-week time frame, tracheostomy and gastric tube placement are often performed at the same time or over several days with each other.

Types

There are several types of feeding tubes and they are used in a wide variety of environments. The nature of the problem causing difficulty swallowing, also known as dysphagia, will help determine the type of tube you are using. Some of them are temporary, while others are long-term or even permanent.

A temporary feeding tube that is inserted into the nose or mouth, down the throat and into the stomach (G tube) or deeper into the intestines (J tube) can only remain in place safely for about 14 years. days.

Throat placement for more than two weeks increases the risk of erosion of the delicate tissues of the throat and esophagus. This can lead to irreversible problems, such as damage to the larynx and throat.

The continuous or long-term feeding tube is designed to be used for months, years, or even continuous use. Like the temporary tube, these tubes can be removed if they are no longer needed, but can remain in place for a long time without risk to the mouth, throat, and esophagus, as food goes directly to the stomach.

Short Term Feeding Tubes

Nasogastric tube : This type of tube is inserted into the nose, through the pharynx, and through the esophagus to the stomach. It can stay in place for four to six weeks before it needs to be removed or replaced with a long-term feeding tube .

Orogastric tube (OG): the tube is the same type as the nasogastric tube, the tube is inserted in the mouth, goes down the pharynx to the esophagus and remains in the stomach. This tube can also stay in place for up to two weeks when it needs to be removed or replaced with a permanent tube.

Temporary feeding tubes

A temporary feeding tube is inserted into the mouth or nose, down the pharynx into the esophagus, and then the end rests against the stomach (tube G) or the middle of the small intestine (tube J).

These types of tubes have a radiopaque tip, which means that there is a small amount of material at the end of the tube that allows it to be seen on X-rays. After installation, an X-ray is taken to confirm correct installation before using the tube.

Continuous / continuous feed tubes

Gastric tube (G tube) : This type of tube allows direct access to the stomach through an incision in the upper left part of the abdomen. This tube bypasses your mouth and throat completely and allows you to take in food, liquid, and medicine without swallowing.

Jejunostomy tube (J-tube) : This tube is inserted through an incision in the abdomen that is lower than the G-tube insertion. It provides direct access to the jejunum, which is the middle third of the small intestine. It is generally smaller than the G tube, which can limit what can be injected into finely divided liquid liquids and powdered medications.

Percutaneous Endoscopic Gastrostomy (PEG) : This term refers to the technique used to insert the gastrostomy tube. Percutaneous endoscopic gastrostomy (through the skin) (using a lighted scope) (inserting a surgical opening into the stomach) describes the procedure used. to place the G-tube and not the G-tube itself.

Placement procedure

The tube insertion procedure is usually quick and may or may not require anesthesia depending on your condition. In very ill patients in the intensive care unit, additional sedation may not be required to place the tube at the patient's bedside.

An endoscope is a long, thin instrument with a lamp and camera on the end that allows the doctor to view the procedure on a monitor. The endoscope is inserted into the mouth, pharynx, and stomach.

Once in the stomach, the light from the telescope can be seen through the skin of the abdomen, showing the gastroenterologist where to make the incision.

A small incision, about half an inch long, is made through which a flexible tube is inserted. Older G-tubes may have a balloon to hold them in place.

The outside of the tube has a cap that allows you to open the tube and gently push food and liquids through the tube into your stomach. With proper tube care, the incision will close more firmly around the tube and any leakage of food or fluids that occurs in the first few days after the procedure should be minimized through healing.

While the incision heals, a notched bandage is placed around the tube. This helps absorb any liquid that may leak from the area.

If there is discharge and irritation of the skin, a barrier ointment can be used as protection. Gently rinsing the area with soap and water and rinsing any soap residue from the area is often all that is needed to care for the area.

In the long term, many patients do not need ointment or gauze at the injury site, but some prefer a bandage in case of drainage to avoid skin irritation or contamination of clothing.

Withdrawal procedure

The removal procedure depends on whether the feeding tube is temporary or permanent.

Removing the feeding tube temporarily

Temporarily removing the feeding tube is quick and easy. It can irritate the delicate tissues of the mouth, throat and nose, but this is usually the minimum amount.

To remove the tube, you empty food and liquids with a large syringe designed for use with a feeding tube. Then it is carefully removed; phasing out takes three to five seconds. If the tip of the tube is intact, indicating that the entire tube has been properly removed, discard it.

Remove the indwelling feeding tube

If you regain the ability to eat and drink well, you can remove the "permanent" feeding tube. Surprisingly, the procedure is quick and, although there is some pain, it is usually mild and brief.

Doctors have different requirements for catheter removal; Some may need to maintain their weight for at least a month by taking all food and fluids through the gastrostomy tube, while others may need a longer period of time.

Once the decision has been made to remove the tube, it can be pulled out, but this will require some force. The patient usually has a disposable towel near the site, and the physician squeezes the tube firmly and slowly but firmly pulls it out of the site.

If there is a balloon inside the stomach, it is deflated before removing the tube, but most types have a flange instead of a balloon and this step is not necessary. The process usually causes a burning sensation, in some cases there is a small amount of blood, but the pain passes quickly.

You can expect the incision to be sutured, but this is not necessary, and a clean dressing is more than enough to keep the patient's clothing clean for days afterward if there is any drainage. The incision is usually closed within a week after the tube is removed .

Get the word of drug information

The decision to install a feeding tube is not an easy one, and it is important to discuss how long-term results can be expected for you or your loved one. For some patients, the use of the tube will be temporary while they recover from the disease. For other patients, the feeding tube can be expected to remain in place for the rest of their lives.

Whether this is right for you or your loved one is the main question. If you are caring for a baby in a situation that may require a feeding tube, your loved one may have a strong opinion on the matter or have never expressed their wishes for long-term medical care.

If you are unsure of your wishes, your common judgment, along with the opinion of the care team and perhaps the advice of others close to you, will guide your decision making.

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