Enteral Nutrition: Don't be afraid, let's talk about this!

You may have seen or heard that someone is given liquid food through a tube when they are unable to eat by mouth. This may sound a little scary and strange. But it is actually a very important medical procedure that can save lives and help keep the body strong. So today, let's talk about feeding through a tube, or in medical terms, enteral nutrition, in a very simple and friendly way.

Simply put, what is tube feeding?

It's very simple. It's a method used to provide nutrition and fluids to someone who is unable to chew and swallow food properly. It involves feeding liquid nutritional food directly into the stomach or small intestine through a very soft, flexible plastic tube.

Think of our digestive system (gastrointestinal tract) as one long road. It starts at the mouth, goes down the esophagus to the stomach, and from there to the small intestine. If for some reason this road is obstructed, this tube is like a shortcut that bypasses the obstruction. Through it, nutrition can be sent directly to where it is needed. Sometimes doctors also use this tube to give medicine.

Why would someone want to be fed through a tube like this?

If you are not getting enough nutrition from eating by mouth, your doctor may recommend this method. This is especially important if you have difficulty chewing and swallowing food, or a condition called dysphagia .

This method provides great support for maintaining the health of your body's metabolism and entire digestive system.

Here are some of the situations where this may be necessary:

• Head or neck injuries: Difficulty swallowing due to cancer or a serious accident.
• Digestive system problems: Conditions such as narrowing of the esophagus, dysmotility of the muscles and nerves of the digestive system.
• Impaired nutrient absorption: Conditions such as severe Crohn's disease can prevent the body from absorbing nutrients.
• Nervous system diseases : Loss of the ability to swallow due to conditions such as stroke or paralysis .
• Coma: This method is essential to keep the body strong when a patient is unconscious.
• Major surgery or illness: After some major surgeries or serious illnesses, it may be difficult to swallow for a while.

What types of reeds are these?

There are two main categories of reeds: those used for short-term use and those used for long-term use.

For short-term use (less than 4-6 weeks)

These are tubes that are usually inserted through the nose. They can be inserted even while lying on a bed in the hospital.

For long-term use (more than 6 weeks)

These are tubes that are usually connected directly to the stomach or small intestine through the skin of the abdomen, usually through a minor surgical procedure.

How do you install this pipe?

The procedure for this will vary depending on the type of tube you need. A nasal tube can be done in the hospital bed. However, a transabdominal tube requires a minor operation. You will be given anesthesia during the procedure, so you will not feel any pain.

• Through the nose: The doctor will carefully apply a lubricant to the tube and pass it through your nose, down your esophagus, and into your stomach. Sometimes, you may be asked to drink some water through the tube to make this easier.
• Endoscopically: In this, a thin, flexible tube (endoscope) with a small camera attached is inserted through the mouth, looked inside the stomach, and marked the exact spot in the stomach where the tube should be inserted. Then, a small incision is made and the tube is inserted. This method is called PEG (Percutaneous Endoscopic Gastrostomy) .
• Radiologically: This is done using X-ray images to find the exact location where the tube should be inserted.
• Surgically: Sometimes this tube is inserted through open surgery or keyhole surgery (laparoscopy).

What should you be careful about when using and caring for the tube?

If you use this tube at home, it is very important to take good care of it. Otherwise, the tube may become clogged and cause infections.

Here's how to keep your tube and the tube insertion site clean:

• Wash daily: Gently wash the skin around the insertion site with soap and water at least once a day. Tell your doctor if there is any discharge.
• Dry thoroughly: After washing, dry the area thoroughly with a clean cloth and keep it dry. Bacteria thrive in moist areas.
• Watch for signs of infection: If the area where the tube was inserted becomes red, swollen, warm, painful, or oozing pus, it could be an infection. Tell your doctor right away.

Here's how to properly care for your pipe:

• Flush regularly: Before and after meals, and before and after giving medication, flush the tube with clean water using a syringe. This will prevent food from getting stuck inside the tube.
• Change the tube at the right time: All tubes need to be changed after a certain period of time. Some need to be changed every year, others every 3-6 months. Your doctor will inform you about this.
• If the tube comes out: This is very important. If it is a new tube inserted through the abdomen, it takes about 6-8 weeks for it to become embedded in the body. If the tube accidentally comes out during this time, it is a medical emergency. Go to the nearest hospital emergency room (ETU) immediately.

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