A really simple question for nurses or doctors...professionals only! 10 pts!

Question

What is an alternative to tube feeding? I know that in some cases, there is NO alternative but i would really like to know if there is one...besides oral feeding. if there isn't, please let me know. i am doing this for a research assignment. thanks.

Answer 1

Tube feeding (via a peg, button) is the most common for people due to inability to swallow or who through trauma to the mouth, accident to throat, severe disability, brain damage and strokes etc. This is short term or permanent.  Parenteral nutrition (Intravenous as in via a major vein) is used when the person cannot take food/fluids through their gastrointestinal tract due to birth defect, major organ failure, genetic disorder etc. Both have pain and danger associated with them. Tube feeding can result in aspiration (choking) if the person is fed lying down and with a fast rate. The site can become infected and depending on the patients health can be slow to heal.  Parenteral feeding is the most dangerous as it is put directly into the blood supply and can cause major problems if not monitored such as clots..

Answer 2

Parenteral (iv) feedings can be used for a short time only. As with any invasive line, there is a higher risk of infection the longer it is left in- especially with the sugar content that the bacteria feed off of. Long term PEG tubes- tubed surgically inserted through the abdominal wall into the stomach have been used for people who are unable to eat at all due to various reasons, including swallowing impairment. These are for more permanent use. Surgical risks apply. Short term a NG(naso gastric) tube can be inserted through the nose down into the stomach. Then liquid nutrition can be delivered to the stomach. It goes through natural openings so less difficulties. Irritation can occur to the linings though. It's best to take nutrition the 'normal' route, but if a condition exists where that is not possible, there are these options. Depends on the situation which is needed. Hope this helps:)

Answer 3

Parenteral nutrition (Intravenous).  But as the adage goes, if the gut works, one should use it.

ADDENDUM:  With Parenteral (IV) nutrition usually via a PICC, the risk of infection is quite concerning so it's really not something we like to do unless we have no choice.  In terms of pain, it's essentially an IV stick, but it's the potential for infection that's most concerning.

With tube feeding, whether nasogastric, orogastric or via a PEG tube, the procedure is done under sedation either by a GI doc or a Interventional Radiologist, and it's really quite straight forward and although there's an inherent risk with any procedure, insertion of a PEG tube is routine.

Answer 4

Others have answered some of this, I just want to point a few things out:

TPN can be used long-term, thought it's normally not because it is incredibly expensive and is usually reserved for patients preparing for or recovering from a dramatic procedure (like Chemo) or who need a brief bowel rest (ulcerative colitis).  It is sometimes used chronically for AIDS, accident or trauma victims, or for children born with malformed or non-existent GI tracts.  (I believe the oldest child kept alive this way lived to be 8 or so).

TPN is actually given most commonly through a central subclavian or jugular line.  The patient can walk around and live with the line, and have the TPN infusion five times a week or once a week for 10 hours.  Patients can also give themselves infusions from a small backpack.

TPN is more prone to complications, because of the reasons mentioned above (increased risk of infection, and atrophy of the GI tract).