Feeding Tubes

In society today, we often have to make decisions. Some of these decisions may mean the life or death of a loved one. The decision of whether or not to administer artificial nutrition and hydration as a form of life support is one decision that some people have to make. I feel that tube feedings, while okay for short term use are fine, but they should not be used as a form of long term care because the risks outweigh the benefits of having a feeding tube.

A tube feeding is a medical procedure that people can accept or deny. Feeding tubes provide a chemically balanced mix of nutrients and fluid to those who are unable to swallow, eat, or drink enough nutrition to maintain proper nutrition and hydration. “ Doctors and nurses, rather than the patients themselves, often control how much will be taken by tube.” (Fade, 2). While providing nutrition and hydration, tube feeding does not offer the same sensory rewards as actual eating and drinking.

Feeding tubes can replace eating and drinking on a short or long term basis. People recovering from surgery often have feeding tubes for a short term to improve the healing process. People with increased nutritional requirements or those who cannot swallow will benefit from short-term use. Feeding tubes when used on a short-term basis are beneficial. However, when used on a long-term basis, feeding tubes are less beneficial because they become a form of life support. I feel they should not be used as a form of long term care.

Whether used for a short or long term basis, there are several types of feeding tubes. Nasogastric tubes are placed into the stomach via the nasal passage. Gastrostomy tubes are inserted through the abdomen wall with a surgical procedure. Another type of feeding tube is the jejunostomy tube, which is also surgically inserted into the small intestine through the abdomen wall.

The administration of a feeding tube does not depend on the amount of time you have the tube. One method of administration is bolus feeding, which involves the rapid administration of 250 to 500 ml of formula several times daily with a syringe. Another type of administration similar to bolus feeding is intermittent feeding. Unlike bolus, it is administered over at least a half-hour. A pump or gravity can be used to control flow rate. A third type of administration is continuous feedings, which is administered over a ten to twenty four hour period. This type is used most in institution settings with a pump. No one type of administration has proven better than any other type of administration.

No matter how it is administered when used on a long-term basis, the complications become very abundant. Adequate nutrition is often not provided due to problems with diarrhea, tube clogging, and aspiration.

Diarrhea strikes almost all patients with feeding tubes. It can occur for several reasons. Most of the time it is because of the type of formula used for feeding. It would be impossible to get proper nutrients from the formula if it is going straight through a person’s system. The diarrhea itself can cause skin problems if not removed promptly.

Promptness is very important when monitoring feeding tubes. If a tube is clogged and it is not reached quickly, the patient is going without nutrients they need. A clogged tube basically starves the person because no formula is permitted to flow through the tube.

Aspiration is another complication that is common among patients with feeding tubes. Aspiration is when food enters the lungs causing the person to choke. The reported incidence of aspiration in people with feeding tubes is .8% to 95%. (Skipper, 455). Aspiration can lead to aspiration pneumonia, which is lethal to patients with feeding tubes.

Another complication encountered by patients with feeding tubes is infection. If the tube is surgically inserted, the insertion site becomes infected easily. The formula used in tube feedings, while sterile before opening, is a prime site for bacteria growth. Infections are treated with antibiotics, which leads to diarrhea in tube-fed patients.

With all of the complications of feeding tubes, the quality of life is very poor. Most people with feeding tubes are in hospitals or nursing homes. They have professionals that take care of them all day long. One nurse described her experience with tube feeders by saying, “ I am willing to take family members in to show them a tube feeder person because lots of times they do not know what they are getting themselves into. They watch the person deteriorate by the quarter of an inch. They look like they are dead, only they