Enteral Nutrition (Tube Feeding) Dietitian and Nutritionist

Important information on enteral nutrition by our registered dietitians:

What is enteral nutrition?

Enteral nutrition is the term used to describe an array of tube feeding practices.

Tube feeding methods:

Tube feeding can be done via several methods or pathways, including:

• Naso-gastric (NG tube), where a tube is fed through a person’s nose down their esophagus and into their stomach.
• Gastrostomy (G tube), where a tube is surgically inserted directly into the stomach.
• Naso-jejunal (NJ tube) or naso-duodenal (ND tube), where a tube is fed through a person’s nose down their esophagus into their small intestine (jejunum or duodenum).
• Jejunostomy (J tube), where a tube is surgically inserted directly into the small intestine.
• G button, a device that is surgically inserted to serve as a portal into the stomach.

Depending on the type of tube that is inserted, a feeding solution (specific to the type of tube the person has) will be run through the tube to ensure adequate nutrition.

The type of tube feed is based on the duration of need. For example, people requiring short-term enteral nutrition would often receive a nasal tube of some kind, whereas those requiring long-term enteral nutrition will receive one of the surgically placed tubes.

Enteral nutrition can be implemented in multiple ways. Tube feeds can run continuously, cyclically or intermittently. The method will be based on the person and circumstances.

The types of feeding solutions will also vary depending on the type of tube a person has and their circumstances. There are commercial formulas available for each type of tube feed. For those with a feeding tube that goes to their stomach, homemade blended formulas are also an option.

A dietitian and nutritionist for enteral nutrition can help in the following ways:

 

• Tube feeding is administered for a multitude of reasons and client populations. It is often used for people that have gastrointestinal (GI) conditions that involve temporary or permanent paralysis, or removal of parts of their GI tract. This could be affiliated with conditions like cancer, IBD, autoimmune disorders, traumatic injury, intestinal blockages, stroke, and so on.
• Tube feeds can also be used to help someone that is malnourished restore their weight and nutritional status at a rate that is faster than regular dietary practices (i.e. if there is a physical or mental barrier to adequate oral nutrition).
• Regardless of the implication, tube feeding serves a significant lifestyle change–particularly for those that require them for months to years at a time. 
• Therefore, working with a registered dietitian (RD) in hospital and at home, even if just in the interim, is very important for preventing complications and ensuring that nutritional needs are being met.
• Dietitians for enteral nutrition are typically the member of a patient’s medical team that will decide which formula is appropriate, and calculate the rate at which it needs to be administered.
• Dietitian for tube feeding can also assess your specific nutritional needs and recommend the best formula to meet your needs.
• Provide education on the use and care of a feeding tube, including tube maintenance, avoiding tube blockages, and resolving tube blockages.
• Help manage possible complications such as aspiration and refeeding syndrome.
• A digestive health dietitian may help manage possible gastrointestinal issues such as nausea, bloating, constipation and diarrhea.
• Monitor tolerance to prescribed formula and feeding regimen, and recommend adjustments as needed.
• Assess and manage hydration needs.
• Monitor body weight, as well as any risks for malnutrition or weight gain.
• Provide support and guidance to achieve optimal health.
• Create personalized feeding regimen which takes into account any other health conditions and lifestyle factors.
• Provide follow-up sessions to monitor progress, address additional concerns, answer questions and adjust the plan, if necessary.
• And more.