Feeding Tubes: The Basics
What is a feeding tube?
Feeding tubes are used to supply nutrition when an individual is unable to eat or absorb nutrients through the gastrointestinal (GI) tract as a result of illness. You can receive both nutrition (vitamins, nutrients and calories), hydration, and medications through the feeding tube.
There are several different feeding tubes, including:
- Nasogastric tube (NGT): An NG-tube is a small thin tube, inserted through the nose and throat and down into the stomach. NGTs are typically used for short periods of time (usually 4 weeks or less).
- Nasojejunal tube (NJT): This is similar to the NG-tube except it passes through the stomach into one of the upper parts of the intestine, called the jejunum.
- Gastrostomy Tube (G-tube or peg tube): G-Tubes are surgically inserted directly into the stomach. G-tubes can be used in individuals with longer term feeding/nutrition needs.
- Gastrostomy-Jejunostomy or GJ-tube (Transgastric-Jejunal or TJ tube): The GJ-Tube is surgically inserted through the abdominal wall, into the stomach and down into the jejunum (intestine).
- Jejunostomy or J-tube: The J-tube is surgically inserted through the abdominal wall, directly into the jejunum, completely bypassing the stomach.
Your care team will decide which tube is appropriate for you based on your diagnosis, length of time for nutrition therapy, functional ability of your stomach and intestines, and nutritional needs.
How are feedings given?
Once your feeding tube is placed, you will slowly start feeding through the tube until you reach your calorie/hydration goal. Tube feeds are started slowly to allow the body to adjust to the feeding, and to monitor for gastroperesis (inability of the stomach to empty food into the intestine), aspiration (when contents from the stomach are coughed up and enter the airway), and nausea or vomiting.
Tube feedings are given either through a bolus (formula is given with a syringe, directly into the feeding tube at regular intervals during the day) or through continuous feeds (delivered through a pump over a fixed period of time; 24 hours, 12 hours, or overnight, in a slower more consistent manner than bolus feeds). Your healthcare provider will instruct you about how to administer medications through the tube (as well as if there are medications that cannot go through the tube or need a special formulation to go through the tube).
Where do I get the feedings?
Your healthcare providers will work with your insurance to identify who will provide your tube feeding formula and supplies. This may be done through a durable medical equipment company (DME) or through a homecare/home infusion provider. You will likely be referred for home nursing to provide teaching and to monitor your progress with self managing your tube feeds. Of note, for most insurance providers to cover tube feedings, those tube feedings must be your only source of nutritional intake. If you are able to tolerate eating my mouth, your insurance company may not cover the cost of your tube feedings.
If your insurance will not cover your formula, there may be patient assistance programs available through the manufacturer. Your oncology social worker or navigator can help refer you to these programs. The Oley Foundation (http://oley.org/) is a non-profit organization that maintains a list of equipment and supplies that have been donated, as well as education, advocacy, and networking opportunities.
Resources for more information
The Oley Foundation: http://oley.org/
This organization strives to enrich the lives of patients dependent on home intravenous nutrition and tube feeding through education, advocacy, and networking.
Feeding Tube Awareness Foundation: http://www.feedingtubeawareness.org/
This organization was formed to support parents of children who are tube-fed, but has lots of useful information for anyone managing tube feedings.