Surgical Nutrition – Enteral Feeding- How does it function and When to Use

1. SURGICAL NUTRITION – ENTERAL FEEDING: HOW DOES IT FUNCTION AND WHEN TO USE By: Dr Valeria Simone MD (Southlake General Surgery, Texas, USA)

2. OVERVIEW Reviewed by Dr. Valeria Simone MD (Southlake General Surgery, Texas) Enteral feeding means taking nutrition through the mouth or with the help of a tube that goes straight to the stomach or small intestine. In reference to the medical setting, the term enteral feeding is frequently used as tube feeding. Intake by means of the gastrointestinal (GI) tract refers to enteral feeding. The GI tract is made up of the mouth, throat, stomach, and intestines. An individual on enteral feeds for the most part has a condition or injury that prevents eating a routine meal by mouth; however, their GI tract is still ready to work. When an individual is fed through a tube, it permits him to get nutrition and keep his GI tract working. Enteral feeding may help to match their caloric intake or might be utilized as a supplement.

4. WHEN DO WE USE ENTERAL FEEDING? Tube feedings may additionally emerge as vital when you can’t eat enough calories to meet your dietary needs. This may additionally happen if you physically can’t eat, can’t consume safely, or if your caloric necessities are expanded beyond your capacity to eat. If an individual is experiencing difficulties with a regular diet, this can pose a risk for malnourishment, weight loss, and very serious health problems. This may additionally appear for a range of reasons. Some of the more frequent underlying motives for enteral feeding include:

5. • a stroke, which can also impair the capacity to swallow • cancer, which may cause weakness, nausea, and vomiting that make it challenging to eat • critical illness or injury, which reduces strength or capability to eat • failure to thrive or inability to eat in children or infants • serious sickness puts the body in a state of stress, making it hard to consume enough nutrients • neurological or movement disorders that amplify caloric necessities while making it even harder to eat • GI dysfunction or illness, even though this may require intravenous (IV) nutrition as a substitute

6. HOW MANY SORTS OF ENTERAL FEEDING ARE THERE? According to Dr. Simone MD, Southlake General Surgery, Texas, there are six foremost sorts of feeding tubes. These tubes may additionally have in addition subtypes depending on precisely where they end in the stomach or intestines. A physician will select the tube placement based on your specific needs, including the required tube size, the duration of enteral feeds, and your digestive abilities A medical expert will also select an enteral method primarily based on tube placement, digestive capabilities, and nutritional needs.

7. The primary sorts of enteral feeding tubes include: •The Nasoenteric tube (NGT) begins in the nostril and finishes in the intestines (subtypes consist of the nasojejunal and nasoduodenal tubes). •Oroenteric tube (OGT) begins in the mouth and finishes in the intestines. •Gastrostomy tube is positioned through the skin of the abdomen directly to the stomach (subtypes consist of PEG, PRG, and button tubes). •Jejunostomy tube is positioned through the skin of the abdomen directly into the intestines (subtypes consist of PEJ and PRJ tubes). Make an appointment online | Southlake General Surgery Texas | USA

8. WHAT IS THE PROCEDURE FOR PLACING THE TUBE? NGT or OGT Placement of a nasogastric tube or orogastric tube, while unbearable, is simple and easy. It does not require anesthesia. Generally, a nurse will measure the size of the tube, lubricate the tip, place the tube in your nostril or mouth, and slide the tube until it is in the stomach. The tube is generally secured to your skin with smooth tape. The nurse or physician will then pull some gastric fluid out of the tube with the help of a syringe. They’ll take a look at the pH (acidity) of the fluid to verify that the tube is in the stomach. At times, we may need a chest X-ray to verify the tube’s placement. Once we confirm its position, we can start using the tube immediately. This ensures a smooth and reliable process to meet your nutritional needs.

9. Nasoenteric or Oroenteric Tubes that end in the intestines frequently require endoscopic placement. This means the use of a thin tube referred to as an endoscope, which has a tiny digital camera on the rear, in order to place the feeding tube in the right place. After the tube placement, the doctor removes the endoscope, and we can confirm the tube’s position by examining the gastric contents and performing an X-ray. This process ensures everything is in the right place while keeping you informed and comfortable. It’s a frequent practice to wait at least four to 12 hours prior to using the new feeding tube. Some individuals will be conscious through this procedure, while other individuals might require conscious sedation. There’s no recuperation from the tube placement; however, it might take an hour or two for the sedative medicinal drugs to wear off.

10. Gastrostomy or Jejunostomy The placement of gastrostomy or jejunostomy tubes is additionally a system that may need conscious sedation or sometimes general anesthesia. To visualize the path for the tube, a medical professional uses an endoscope and then creates a small incision in the abdomen to thread the tube into the belly or intestines. Subsequently, they secure the tube to the skin. Many endoscopists decide to stand by for at least 12 hours prior to using the new feeding tube. Recuperation may take up to seven days. A few people experience uneasiness at the tube insertion site; however, the cut is so small that it commonly recuperates well overall. Your healthcare provider may prescribe antibiotics to prevent infection

11. Enteral and parenteral feeding Sometimes, enteral feeding may not be an alternative. If you’re at risk for malnutrition and don’t have an efficient GI framework, you may require a choice called parenteral feeding. Parenteral feeding involves delivering nutrition through an individual’s veins, typically through the insertion of venous access equipment such as a port or a peripherally inserted central catheter (PICC or PIC line) to administer liquid nutrition. If this is going to be your supplementary nutrition, it’s known as peripheral parenteral nutrition (PPN). When you’re taking the entirety of your nutritional necessities through an IV, it’s regularly known as Total Parenteral Nutrition (TPN). Parenteral feeding could be a daily life-saving alternative much of the time. But it’s desirable to use enteral nutrition, assuming there is any chance of this happening. Enteral nutrition most intently emulates regular eating and can assist with immune system function. Make an appointment online | Southlake General Surgery Texas | USA

12. WHAT ARE THE LIKELY COMPLICATIONS OF ENTERAL FEEDING? There are a few complications that can happen because of enteral feeding. A few of the most frequent include: • aspiration, which is a meal going into the lungs • refeeding syndrome, risky electrolyte imbalances that may show up in individuals who are very malnourished and begin taking enteral feeds • tube infection or insertion location • vomiting and nausea may happen due to feeds that are too big or fast, or from delayed emptying of the stomach • irritation of the skin at the tube insertion area • diarrhea because of a liquid diet or due to medications • dislodgement of the tube • blockage of the tube can occur if it is not flushed properly There are generally no long-term problems with enteral feeding. Once you resume a regular diet, you may experience slight discomfort in digesting since your body adjusts to regular meals.

13. WHY SHOULDN’T I CHOOSE TO HAVE ENTERAL FEEDING? The primary reason an individual wouldn’t have the option to have enteral feeds is – if their stomach or intestines aren’t working appropriately. Let’s explore more: Surgical Nutrition - Enteral Feeding: How does it function and When to Use - Southlake General Surgery

14. APPOINTMENT For more information, guidelines, and consultation on Surgical Nutrition at Southlake General Surgery or Percutaneous Endoscopic Gastrostomy (PEG) tube, please contact our healthcare expert at +1(817)748-0200. You can also make an online appointment with us. Follow us on Facebook and YouTube. Source: Surgical Nutrition - Enteral Feeding: How does it function and When to Use - Southlake General Surgery

15. THANK YOU! SOUTHLAKE GENERAL SURGERY 1545 E. Southlake Blvd, Suite 270 Southlake, TX 76092 EMAIL: info@southlakegeneralsurgery.com VISIT US AT: www.southlakegeneralsurgery.com