Home Enteral Nutrition

A way of delivering nutrition directly to your stomach or small intestine is called home enteral nutrition or tube feeding.

This feeding will be suggested by your doctor if you cannot eat enough to get all the nutrients that you need.

Doctors refer to home enteral nutrition if it occurs outside of the hospital.

A home enteral nutrition team will teach you how to feed yourself through a tube and will also give you support if ever you encounter problems.

Home enteral nutrition may be suggested if your digestive system works normally but you have difficulty eating such as:

• cancer – neck or head cancers or cancer treatment which makes it painfully difficult to swallow
• neurological problems – such as amyotrophic lateral sclerosis (ALS) or stroke
• gastrointestinal problems – such as bowel obstruction and gastroparesis
• trauma – such as injury to your digestive tract

The types of feeding tubes are:

• feeding tube passed through the nose – the tube will be inserted through your nose and into your stomach (nasogastric tube) or small intestine (nasojejunal tube) if you will need a feeding tube for a month or less
• feeding tube passed through the skin on your abdomen – the tube will be placed through the skin on your abdomen and into your stomach (gastrostomy) or into your small intestine (jejunostomy) if you will need longer term tube feeding

It will depend on your situation which tube is the best for you.

Here are the most common reasons for home enteral nutrition.

While many patients recover from their conditions and are discharged from the hospital without any further treatments, some patients still require home enteral nutrition.

This allows patients who are well enough to receive nutrition at their home.

Some of the potential risks of tube feeding include:

• gastrointestinal side effects such as vomiting, nausea, stomach pain, diarrhea and bloating
• metabolic complications such as changes in blood chemistry and electrolyte levels (high blood sugar level and low sodium level)
• mechanical complications due to clogged or displaced feeding tubes
• bacterial contamination of enteral feed that can cause serious infection
• reflux and aspiration

In preparing for home enteral nutrition, your dietician will advise you of your nutritional needs. He/she will prescribe a liquid formula and this will include fat, protein, fluid, carbohydrate, minerals and vitamins.

Tube feeding can be given in three different ways using a pump, gravity drip, and syringe. A pump is used for continuous feeds without stopping for 8 to 24 hours.

A gravity drip is used to give larger amounts of formula over a short period of time mostly 4 to 6 times each day. A syringe is used for larger amounts of formula and is the fastest method.

Here you can find out what to expect from your home enteral nutrition

Feeding tubes can be placed in different places along your gastrointestinal tract. A gastrostomy will be placed in the stomach during the procedure.

A nasogastric tube is a tube that will be put in your nose down in your stomach. A jejunostomy will be placed in the middle part of the small intestine called the jejunum.

You are not allowed to give feeds while the patient is laying flat on a bed. Sit on a chair or lay with your head raised to at least 30 degrees.

You have to be in this elevated position until after the feeding. Consult your doctor immediately if you started choking or have difficulty breathing while feeding.

If you do not understand your home enteral nutrition results, consult with your doctor.

You will have a care team that will work with you to teach and support you in doing home enteral nutrition.

The family member that will take care of you will have the training to prepare, administer and monitor how your tube feed.

You will need to follow-up on the dietician and will need to stay in touch even with your care team.