Tube Feeding 101: Things Everyone Should Know About Tube Feeding

Tube feeding helps people who have trouble eating or getting the right nutrition to stay healthy and survive. Whether you’re supporting a loved one who relies on tube feeding, learning how to support someone who is undernourished or experiencing tube feeding firsthand, here’s our guide to things everyone should know about tube feeding. 

What is tube feeding?

Tube feeding is a process where a feeding tube is used to supply nutrients to people who are unable to consume food orally or get enough nutrients through eating. Tube feeding is also referred to as ‘enteral nutrition’. 

Tube feeding is an intrusive yet effective way of ensuring your body gets the nutrition it needs. People have different nutritional needs. An individual’s nutritional needs can be determined by underlying health conditions, weight/height and level of physical activity.

Who requires tube feeding?

Tube feeding may become necessary when an individual is unable to physically consume the required nutrients and meet their caloric requirements. 

Fact: A gastroenterologist is a doctor specialising in digestive disorders.

A doctor is likely to recommend tube feeding if an individual is malnourished, underweight, facing significant health issues or having trouble consuming food. Some common reasons that individuals may require tube feeding include: 

• Struggling to consume food or swallow, including experiences of choking or restrictions in the oesophagus
• Eating disorders or other feeding issues
• Assist with recovery from a condition
• People with lost ability to swallow due to ventilators or endotracheal tubes placed in their airways.  

What are the different types of tube feeding?

The type of feeding tube will depend on an individual’s nutritional needs, medical history and underlying health reasons. 

There are six different types of tubes a doctor can recommend, depending on where the feeding tube ends in the body and based on its required length of use. Some individuals will only need a tube in the short term, whereas some individuals may be reliant on tube feeding in the long term.

Using the right type of tube is important as some tubes are intended for limited use, whereas long-term or permanent tube feeding arrangements can be used for several years or across a lifetime.

Types of feeding tubes that end in the stomach

1. Nasogastric tube or NGT tube

Temporary tube transferring nutrients through the nose and ending in the stomach.  

2. Orogastric tubes or OGT tubes

Temporary tubes passing nutrients through the mouth and also end in the stomach.  

3. Gastric tube or ‘G tube’

A feeding tube is inserted through the skin by making an incision above the abdomen, and ending in the stomach. G tubes can also be placed through a surgical technique referred to as percutaneous endoscopic gastrostomy (PEG). This option is typically only for people with healthy, functioning stomachs. As it’s directly connected to the stomach, the G tube does not rely on swallowing or oral consumption. Gastric tubes are also known as PRG or button tubes.

Types of feeding tubes that end in the intestines:

4. Nasoenteric tubes

Also known as nasojejunal and nasoduodenal tubes, these feeding tubes start in the nose and end in the intestines. 

5. Oroenteric tubes

Feeding tubes that start in the mouth and end in the intestines.

6. Jejunostomy tube or ‘J tube’

A J tube is inserted through a cut in the low abdomen to directly connect it to the small intestine. The J tube is typically smaller than a G tube. Enteral feeding tubes are also not recommended for people with bowel problems or severe diarrhoea. The J tube can also be called PEJ and PRJ tubes. 

What is enteral feeding?

Feeding tubes that bypass the throat and directly supply liquid nutrients to the gastrointestinal tract, stomach or small intestine are known as a form of enteral feeding. 

Enteral feeding can help prevent choking when people have trouble swallowing. As nutrition is transferred directly to the stomach or intestine, enteral feeding can be a safer option for some individuals as it reduces the risk of food or fluids going down the trachea and relies on a body’s normal digestive patterns. 

For individuals with an unhealthy gastrointestinal system, enteral feeding may not be a suitable option. Enteral feeding may also cause some complications, such as aspiration or food entering the lungs, infection of the tube, nausea or vomiting or tube blockages. In such instances, medical professionals may recommend parenteral feeding.

Parenteral feeding supplies nutrition through an individual’s veins through an access device such as a catheter. Although enteral nutrition is preferable, parenteral feeding can provide a necessary alternative for some individuals.  

What types of nutrients are passed through a feeding tube?

Any liquified food items, along with powdered medicines, can be passed in a feeding tube.

Liquid mixtures can contain regular nutrients that people consume daily, including carbohydrates, proteins, fat, vitamins, minerals, and water. But the different mixture of nutrients will depend on the unique nutritional needs of an individual, including:

• Energy needs
• Fibre and protein needs
• Calcium or other vitamin deficiencies 
• Lactose intolerance or allergies. 

Some individuals may prefer prepackaged formulas, while others can prefer their own liquid mixtures. 

When considering the types of nutrients or formula you need for a feeding tube, we strongly recommend you consult a medical professional and an Accredited Practicing Dietician to help select the most appropriate mode of feeding and type of mixture for your lifestyle and nutritional needs. 

An Accredited Practicing Dietician will be able to support you with: 

• Identifying the right formula based on an individual’s nutritional needs
• Creating a tailored feeding plan based on an individual’s height, weight, age and overall health
• Support in determining the type of feeding tube most appropriate. 

What are the benefits of tube feeding? 

Some of the benefits of tube feeding include:
1. Tube feeding helps maintain a balanced and nutritional diet

Tube feeding can assist people who struggle to consume food, people who face health problems or people with undernutrition by providing them with the required carbohydrates, protein, and fats to support the body.

2. Tube feeding helps stay hydrated

Tube feeding can provide fluid, keeping individuals hydrated.

3. Tube feeding supports medicinal needs

Pills can be powdered and mixed with water before being passed through feeding tubes, supporting medicinal intake and recovery.

4. Tube feeding can reduce stomach pain

Suction from the feeding tubes can remove unwanted gas in the stomach, reducing bloating or enlargement. Suction from feeding tubes can also remove unwanted food particles, reducing the risk of stomach pain and further bloating or nausea. 

What happens when you get a feeding tube?

The process of placing a feeding tube depends on the type of tube that is being inserted. 

1. Inserting tubes that end in the stomach: 

Nasogastric (NGT tubes) or orogastric tubes (OGT tubes) are temporary tubes that pass nutrients through the nose or mouth to the stomach. The placement of NGT or OGT tubes are straightforward, and while there is a level of discomfort, the procedure is typically painless and without anesthesia. A nurse or health practitioner will place the tube through the nose and mouth, advancing until the tube reaches the stomach. To confirm the tube has reached the stomach, some gastric liquid will be removed from the stomach and tested to confirm its acidity matches that of the stomach. When the tube is in place, it can be used immediately.

Gastric tubes that rely on an incision in the abdomen may require the use of a sedative or general anesthesia. The procedure can take between 30-45 minutes and recovery may take up to five days.  

2. Inserting tubes that end in the intestines:

Nasoenteric tubes or oroenteric tubes are long-term feeding tubes that connect to the intestines. The placement of these tubes requires an endoscope, a tube with a tiny camera at the end that is used to monitor where the tube has been placed correctly. An X-ray may often be utilised to confirm the position and placement of the tube. 

A nasoenteric tube or oroenteric tube can be utilised between four to twelve hours after placement. 

Jejunostomy tubes that require a surgical incision in the abdomen also require the use of a sedative, painkiller or general anesthesia, and may take up to a week for a full recovery. 

Can you remove a feeding tube? 

The procedures for removal depend on whether it is a temporary or permanent feeding tube. Temporary feeding tubes can be removed through a quick procedure that uses a syringe to empty the tube of fluids before the tube is safely withdrawn from the body. 

Although the process of removing a permanent feeding tube is relatively similar to temporary tubes, the removal of a permanent feeding tube may need more force, with the risk of some pain and discomfort. 

Making a decision for a loved one:

The decision to get a feeding tube for yourself or a loved one can be extremely complex and difficult to navigate.

Like any tricky decision in life, the best way to approach it is to have an honest and open conversation with your loved one if they are able to do so. Feeding tubes are often triggered by a health complication and a loved one may not be able to consciously express their desires or thoughts about the decision. 

In these cases, it’s important to consult with trusted healthcare providers and practitioners who can provide a thorough assessment of the options that may best suit a loved one.  

The decision to get a feeding tube can be based on several factors that go beyond an individual’s medical history, health or illness. The decision may also affect an individual’s sense of autonomy and independence.

Tip: practice empathy and active listening by approaching a conversation without judgment, listening to their feelings, asking intentional questions and giving them space to voice their questions and concerns. 

How to get help? 

Transitioning to tube feeding can take up a lot of time and investment. The financial cost of inserting a feeding tube or aftercare can add further pressure to an already difficult decision. 

If you’re considering tube feeding for a loved one, here are some financial resources to assist you on your medical journey. 

Resources across Australia: 

Carer Payment

Provides payment for Australian residents who give constant care to someone with a severe disability, illness, or an adult who is frail aged. Learn more about Carer Payments here.

Carer Allowance

Supports people who provide additional daily care to someone with a disability or medical condition or an adult who is frail aged. The payment supports people who are providing care to someone who’ll need support for at least 12 months. Learn more here.

NDIS

Australia’s first national Scheme for people with disability, providing funding directly to individuals with a disability caused by a permanent impairment. Learn more here. 

Child Disability Assistance Payment

If you’re caring for a child with a disability or serious illness, you may be eligible to receive a yearly payment. Learn more about the criteria here. 

Crisis and special help

From social workers who provide short term counselling, to one off crisis payments, you may be eligible to access support. Learn more here.

How Homage can help:

If you or a loved one requires support with tube feeding, Homage’s care professionals can provide you with a range of benefits to cater to your needs. 

Here are some ways Homage can support you:

1. Our nurses provide medical assistance or support with home treatments

Every Homage nurse is a Registered Nurse, so you can rest assured that you or a loved one is receiving the best care possible. – PEG feeding

2. Care in the comfort of your home

Our qualified care professionals provide you or a loved one with a range of support in the comfort of your home.

3. Access to support services

Whether it’s transport to medical appointments, additional companionship at home or help with activities, our care professionals are available to assist you as you transition to tube feeding or recover from a tube withdrawal.

Learn more about how Homage can support you or a loved one who relies on tube feeding by reaching out to our team today.