ENTERAL NUTRITION

Nurse (N): Good morning.

Patient (P): Good morning miss.

(N): Ok. So, as you know, you need to be tube fed with respect to your decreased appetite, which makes your caloric intake insufficient, and in order to avoid serious health issues. This is what we call "enteral feeding".

(P): To tell you the truth, I’m a bit apprehensive about this. And frankly I just don’t really get it.

(N): You needn’t worry about that. All people of all ages receive tube feeding, from infants to adults, depending on their needs, that might go from decreased appetite to difficulty swallowing, post-op interferences or illness.

(P): Ok, but what kind of food is then given? I mean solid or liquid?

(N): Liquid of course, which is a special mixture that contains vitamins and minerals, protein, carbohydrates, I mean sugar, and fats.

(P): And the tube should be inserted into the throat, isn’t it? I already feel bad about that.

(N): It depends, and anyway people live very well on tube feeding for as long as they need. However, it’s usually used for a short time, until the person is able to eat by the mouth.

(P): But then again, how can tube feeding be given?

(N): This can be given, for example, through the nose to the stomach or small intestine, which we call nasogastric feeding. However, sometimes the tube is placed through the skin directly into the stomach or small intestine. This is called gastrostomy. As for you, the doctor has recommended the nasogastric feeding.

(P): Aren’t you using any anesthesia for that?

(N): It’s fairly straightforward and painless, and therefore doesn’t require anesthesia.

(P): And how can this be done?

(N): Typically, we’ll lubricate the tip of the tube and place it in your nose and advance it until we reach the stomach, and we secure it to your skin by using a soft tape. We might use a chest X-ray to confirm the placement, and then the tube can be used immediately. Otherwise, we may just use an endoscopic placement, with a tiny camera inside a thin tube in order to see exactly where we’re going. Then the endoscope is removed and the place of the feeding tube is be confirmed.

(P): Would there be any complications as to this, I mean the tube insertion and… I don’t know, any adverse effects.

(N): The most common side effects are skin irritation, nausea and vomiting, or else diarrhea due to the liquid diet that we give you. Other more delicate effect may occur, but you’ll be under supervision anyway, even at home. There aren’t any long-term complications anyway. But we need you to tell us what you feel about that and about any uncommon changes to your daily life and health condition. And you can resume normal eating soon. Ok?

(P): Fine by me.