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Encyclopedia > Feeding tube

A feeding tube is a medical device used to provide nutrition to patients who cannot or refuse to (q.v. hunger strike) obtain nutrition by swallowing. The state of being fed by a feeding tube is called enteral feeding or tube feeding. Placement may be temporary for the treatment of acute conditions or lifelong in the case of chronic disabilities. Many patients treated using a feeding tube lack the ability to survive on their own without such technology. A hunger strike is a method of non-violent resistance in which participants fast as an act of political protest, or to provoke feelings of guilt or to achieve a goal such as a policy change. ...


A variety of feeding tubes are used in medical practice. They are usually made of polyurethane or silicone. The diameter of a feeding tube is measured in French units (each French unit equals 0.33 millimeters). They are classified by site of insertion and intended use. This article needs to be cleaned up to conform to a higher standard of quality. ... A millimetre (American spelling: millimeter), symbol mm is an SI unit of length that is equal to one thousandth of a metre. ...


Feeding tubes can be used for the force-feeding of prisoners on hunger strike, a controversial use. The World Medical Association prohibits the involuntary force-feeding of hunger strikers (except in cases of coma or mental impairment) through the Declaration of Tokyo (1975) and the Declaration on Hunger Strikers (1991). Feeding tubes are sometimes used on prisoners in a manner which can be categorized as torture, as allegedly at Guantanamo Bay detention camp (using nasogastric tubes). [1] Force-feeding is the practice of feeding someone against his or her will. ... A hunger strike is a method of non-violent resistance in which participants fast as an act of political protest, or to provoke feelings of guilt or to achieve a goal such as a policy change. ... The World Medical Association (WMA), an international organization of physicians, was formally established on 17 September 1947, pursuant to deliberations and decisions taken in the First General Assembly of WMA held in Paris, France. ... For other uses, see Torture (disambiguation). ... Wikisource has original text related to this article: Detention, Treatment, and Trial of Certain Non-Citizens in the War Against Terrorism Wikisource has original text related to this article: Statement of Alberto J Mora on interrogation abuse, July 7, 2004 Guantanamo Bay detention camp is a joint military prison and... A nasogastric tube (NG tube) is a plastic tube, inserted into a nostril through the nose, into the throat, down the oesophagus and into the stomach. ...


Feeding tubes are also used for the force-feeding of animals, such as the ducks and geese used to produce foie gras. Subfamilies Dendrocygninae Oxyurinae Anatinae Aythyinae Merginae Duck is the common name for a number of species in the Anatidae family of birds. ... Geese redirects here. ... Pâté de foie gras redirects here. ...


Types of feeding tubes

Nasogastric

A nasogastric feeding tube, or "NG-tube", is passed through the nares, down the esophagus and into the stomach.


Gastric feeding tube

A gastric feeding tube, or "G-tube", is a tube inserted through a small incision in the abdomen into the stomach and is used for long-term enteral nutrition. The most common type is the percutaneous endoscopic gastrostomy (PEG) tube. It is placed endoscopically: the patient is sedated, and an endoscope is passed through the mouth and esophagus into the stomach. The position of the endoscope can be visualized on the outside of the patient's abdomen because it contains a powerful light source. A needle is inserted through the abdomen, visualized within the stomach by the endoscope, and a suture passed through the needle is grasped by the endoscope and pulled up through the esophagus. The suture is then tied to the end of the PEG tube that will be external, and pulled back down through the esophagus, stomach, and out through the abdominal wall. The insertion takes about 20 minutes. The tube is kept within the stomach either by a balloon on its tip (which can be deflated) or by a retention dome which is wider than the tract of the tube. In anatomy, the stomach is a bean-shaped hollow muscular organ of the gastrointestinal tract involved in the second phase of digestion, following mastication. ... A percutaneous endoscopic gastrostomy (PEG) is the making of access to the digestive tract through the abdominal wall. ...


Gastrostomy tubes can also be placed in "open" procedures through an incision with direct visualization of the stomach, as well as via a laparoscope. Gastric tubes are suitable for long-term use: they last about six months, and can be replaced through an existing passage without an additional endoscopic procedure. The G-tube is useful where there is difficulty with swallowing because of neurologic or anatomic disorders (stroke, esophageal atresia, tracheoesophageal fistula), and to avoid the risk of aspiration pneumonia. It is also used when patients are malnourished and cannot take enough food by mouth to maintain their weight. They also can be used in "reverse" to drain stomach contents. Esophageal atresia is a congenital medical condition (birth defect) which effects the alimentary tract. ... This article is about human pneumonia. ...


Jejunostomy tube

A jejunostomy tube is similar to a gastric tube, though generally has a finer bore and smaller diameter, and is surgically inserted into the jejunum rather than the stomach. They are used when the upper gastrointestinal tract must be bypassed completely, and can be used as soon as 12 hours after surgery. This type of tube is usually used for people who are at high risk for aspiration. Diagram of the Human Intestine In anatomy of the digestive system, the jejunum is the central of the three divisions of the small intestine and lies between the duodenum and the ileum. ... Look up aspiration, aspirate in Wiktionary, the free dictionary. ...


These small bore tubes are prone to clogging, particularly with some medications and if not flushed as directed. Feeding through these tubes are generally commercially prepared to provide adequate nutrition and to not result in clogging when used with a pump or with drip feedings.


Gastrojejunostomy tube

Dual-lumen feeding tubes are available. Typically, the gastric lumen is used for decompression. The jejunal lumen is used to administer feedings. Either a percutaneous or open technique can be used. The jejunal portion of the tube can occasionally migrate back into the stomach, often requiring endoscopic repositioning.


Effectiveness

Nutritional supplementation is not necessary if the patient is not eating for four days or less[1] and maybe also if duration is seven days or less.[2]


A randomized controlled trial found no difference between the NG tube and PEG tube in stroke patients.[2] A randomized controlled trial (RCT) is a form of clinical trial, or scientific procedure used in the testing of the efficacy of medicines or medical procedures. ...


Complications

Damage to nearby structures, most commonly the colon, can occur with percutaneous techniques. Dislodgement of the tube can occur, leading to peritonitis in certain circumstances. Feeding tubes can become occluded or inadvertently pulled out. The tube can migrate distally and obstruct the pylorus, leading to gastric outlet obstruction. Abdominal fascial dehiscence can occur with an open technique. After removal of the feeding tube, a gastrocutaneous fistula can result if the tract does not close. It has been suggested that this article or section be merged with Large intestine. ...


Withdrawal

Tube feeding, like all medical treatments, can be declined or withdrawn, especially in the setting of a terminal illness where its use would not alter the ultimate outcome. Actively withdrawing an existing feeding tube is considered by some to be a form of active euthanasia, while deciding not to place one could be considered passive euthanasia. For mercy killings not performed on humans, see Animal euthanasia. ...


See also

Bioethics is the ethics of biological science and medicine. ... Force-feeding is the practice of feeding someone against his or her will. ... Theresa Marie Terri Schiavo (December 3, 1963 – March 31, 2005), from St. ...

References

  1. ^ de Lédinghen V, Beau P, Mannant PR, et al (1997). "Early feeding or enteral nutrition in patients with cirrhosis after bleeding from esophageal varices? A randomized controlled study". Dig. Dis. Sci. 42 (3): 536-41. PMID 9073135. 
  2. ^ a b Dennis MS, Lewis SC, Warlow C (2005). "Effect of timing and method of enteral tube feeding for dysphagic stroke patients (FOOD): a multicentre randomised controlled trial". Lancet 365 (9461): 764-72. doi:10.1016/S0140-6736(05)17983-5. PMID 15733717. 

A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ...

External links


  Results from FactBites:
 
Tube Feeding (1334 words)
Feeding tubes may be inserted through the nasal passageway for short-term use, but for those patients who require longer use of the tube, it is customary to place the tube directly into the stomach through the abdominal wall.
The feeding tube may also be put in place in anticipation of other treatments such as radiation or chemotherapy, allowing the patient to adapt to its use prior to treatments.
After the tube is placed, a registered dietitian or a nurse who specializes in nutrition should assess the patient to determine their nutritional needs, the amount of calories, protein, and fluids that will be necessary, as well as the most appropriate nutritional formula and how much of that formula will be needed each day.
Feeding Tubes for Infants and Children with Sensory, Swallowing and Oral Motor Problems: Issues (3153 words)
Tube feedings may be initiated as a temporary measure to increase the child's nutritional status and improve growth.
Feeding tubes are given to support life, and to make it easier for the child to grow without the risk of malnutrition, excessive fatigue, or aspiration.
When tube feedings are initiated immediately after birth, the infant lacks the opportunity to build associations between positive sensations in the mouth and the reduction of hunger, or the social interaction with another person that surrounds a meal.
  More results at FactBites »


 
 

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