How Does a Feeding Tube Work?

A feeding tube is a medical device that helps deliver nutrition, hydration, and medication through a tube into your stomach or small intestine. This can be a life-saving intervention if you have an underlying condition that makes it difficult to eat or drink safely by mouth.

Depending on your exact situation, your healthcare provider can place a feeding tube in your body for a few days or weeks, or it may become the primary way you receive nutrition for the rest of your life. There are several types of feeding tubes and your provider can help you figure out the best feeding tube to use for your specific needs.

It's worth noting that feeding tubes do come with some risks including leaking, infection, or aspiration (or, sucking food into your airways by mistake). However, feeding tubes are a safer alternative to total parenteral nutrition (TPN), which occurs when you receive through an intravenous (IV) catheter.

Purpose and Function

When you aren't able to get the nutrition you need or have trouble swallowing food, your healthcare provider may recommend inserting a feeding tube into your stomach or small intestine. Using a feeding tube can help deliver the proper nutrition, hydration (water), and medication you need to meet your daily needs.

Many health conditions may warrant the need for a feeding tube, such as a bowel obstruction (or, other gastrointestinal problems) and certain cancers. Your healthcare provider can help you determine the exact type of feeding tube you need, how long you need the device for, and which feeding method to use to get you the nutrients your body requires.

Additionally, your provider will help you decide on which feeding schedule is best fit for you. Some common examples of feeding schedules include:

• Continuous feeding: You receive nutrition formula through the feeding tube at a slow and steady pace at all times. Most people who use this type of feeding schedule tend to be in the care of a provider within a hospital setting.
• Bolus feeding: You are able to get larger amounts of nutrition that go through the feeding tube all at once. Generally, these feeding sessions only last 20 to 30 minutes. This type of feeding schedule is most common in home settings where you are under the guidance of a caregiver.
• Intermittent feeding: This type of schedule is a bit similar to continuous feeding, but instead of receiving nutrition constantly, you get the food and water you need at strategic points of the day. For example, an intermittent feeding session may occur overnight and access to food is turned off during the day so you can develop an appetite and practice eating on your own. Oftentimes, this schedule is helpful if you're undergoing a medical procedure or are transitioning back to a regular diet.

Why You Might Need a Feeding Tube

You'll likely need a feeding tube if you're not able to get the nutrition and hydration you need through regular methods of eating and drinking or have trouble swallowing. You might require a feeding tube due to any of the following conditions or situations:

• Living with a neurological (brain-related) condition, such as Parkinson's disease, dementia, stroke, or multiple sclerosis, which can make you forget how to swallow or cause you to lose control of the muscles that help you swallow food
• Dealing with problems with your esophagus, such as a stricture, tumor, or tear, which can make it difficult to swallow food or cause food to enter your airways
• Being in a coma, whether medically induced or due to a severe illness or injury
• Undergoing chemotherapy or radiation for cancer, which may cause you to lose your appetite
• Experiencing severe symptoms of conditions such as HIV, cystic fibrosis, or sepsis
• Receiving treatment and support for anorexia nervosa
• Having extreme difficulty taking medications properly (which is more common among young children)

Types of Feeding Tubes

There are three main types of feeding tubes: nasogastric tubes, gastrostomy tubes, and jejunostomy tubes. What tube you need depends on a variety of factors including the reason you need a tube, the length of the tube you need, and how well you're able to swallow.

Your healthcare provider can help you determine which of the following tubes are best fit for your needs:

• Nasogastric tube: A healthcare provider inserts this tube into your nose and down into your stomach. You'll likely use this tube if you don't have any trouble with vomiting, acid reflux, or gastric emptying (or, the process of food passing from your stomach to your small intestine). These types of tubes are most common in hospital settings and are often intended for short-term use. Using these tubes for too long can increase the risk of a nasal infection.
• Gastronomy tube: Sometimes called a G-tube, a healthcare provider will insert this tube directly into your abdominal wall and into the stomach to establish a route for nutritional feeding and administering medication. This tube is the most common type if you need a feeding tube for long-term use.
• Jejunostomy tube: For this procedure, your healthcare provider will insert this tube through your abdominal wall and into your jejunum, which is a part of your small intestine. Generally, this type of tube is most common for people who will be transitioning to eating a regular diet by mouth in a short period of time.
  

What to Expect When Using a Feeding Tube

Your feeding tube experience will vary greatly depending on factors such as what feeding tube you're using, the nutritional formula you need, what feeding schedule you're on, and how long you need the feeding tube. Generally, your healthcare provider will tailor your treatment plan to meet your exact needs and go over specific guidelines that you and your caregiver should know about your feeding tube.

However, there are some common guidelines that everyone with a feeding tube can expect to learn and follow. These guidelines include: how to cleanse your skin around the insertion point of the feeding tube and how to properly take care of the tube itself.

Most people who have a feeding tube experience irritation or soreness around the skin where the feeding tube was inserted. Once your feeding tube procedure is complete, your healthcare provider will teach you how to take care of the skin around the tube so that you prevent the risk of experiencing irritation or infection. Generally, they may ask you to use water, a clean cloth, and some type of hygienic solution to clean the insertion site at least twice a day.

It's equally important to clean the tube itself as it is to take care of the skin around the tube. Caring for your tube can ensure that the tube doesn't become clogged or dislodged. Here are some basic caring instructions you can expect from your provider:

• Treat your feeding tube gently and do not pull or yank on it
• Flush the tube with water after administering nutritional formula or medication
• Ground oral medication (pills) into a fine, powder-like consistency to prevent pieces of the pill from getting stuck in the tube
  

Risks

While tube feeding can be a necessary and life-saving intervention, it does come with risks. If you receive a surgical procedure to place your tube, you may be at greater risk of experiencing the following complications:

• Bleeding
• Infection
• Allergic reaction
• Extra tissue (called granulation tissue) that forms around the tube site during feeding

Even after surgery and once the tube is secure in place, there are some risks of complications that you might have, including:

• The tube becoming dislodged or breaking
• Leakage around the tube site
• Obstruction in your intestines
• Infection at the tube site
• Peritonitis, or an infection of the lining of the abdomen
• Gastroenteritis, or inflammation of the digestive system
• Diarrhea
• Constipation
• Nausea and vomiting
• Cramps
• Bloating
  

Some people who have a feeding tube may be at risk for something called refeeding syndrome, which occurs when someone who is malnourished starts eating again. This condition can cause symptoms such as muscle weakness, nausea, fatigue, low blood pressure, headache, blurry vision, and cramps. You may be at an increased risk of experiencing symptoms of refeeding syndrome if you:

• Live with conditions that increase your risk for malnourishment, such as anorexia nervosa, cystic fibrosis, or inflammatory bowel disease
• Are an older adult
• Drink excessive alcohol
• Have just undergone surgery
• Were fasting for a long period of time
• Underwent chemotherapy

When to Contact a Healthcare Provider

If you have a feeding tube, it's important to stay in contact with your healthcare provider. It's especially critical to reach out to them if you experience any of the following:

• Your tube becomes dislodged, blocked, clogged, or comes out
• Signs of infection such as swelling, fever, chills, or redness around the insertion site
• Severe pain or blood around the site
• Abdominal pain
• Prolonged vomiting
• Excessive diarrhea
• Constipation that doesn't go away or the inability to pass gas
  

A Quick Review

Feeding tubes are important medical devices that can help give you nutrition, hydration, and medication when you're not able to get the nutrients you need or swallow properly. Several conditions may warrant the need for a feeding tube, such as certain cancers, esophageal concerns, and neurological disorders.

There are several different types of tubes and procedures that your healthcare provider can choose from. The exact feeding tube and feeding schedule you use will depend on your specific needs and overall health. Having a feeding tube does come with certain risks, such as becoming more prone to infections or uncomfortable symptoms like diarrhea or nausea. That's why keeping in touch with your provider while using the feeding tube is essential.