Enteral nutrition delivery technique. 2003

Sarath Gopalan, and Sudeep Khanna
Pushpawati Singhania Research Institute, New Delhi, India. crnss@hotmail.com

OBJECTIVE Ingestion and absorption of a nutritionally adequate diet is necessary to maintain normal body composition and organ function. Patients with all kinds of diseases are at increased risk of developing nutritional abnormalities from anorexia, dietary restriction, malabsorption, increased intestinal losses or altered nutrient requirements. Therefore, it is important for doctors to understand the general principles of clinical nutrition for optimal management of patients with various disorders. The purpose of this review is to highlight an important aspect of nutrition: methods for enteral nutrient delivery. Enteral feeding is the preferred method to provide nutritional support in patients who cannot or will not eat but who have a functional gastrointestinal tract. The placement of a small-diameter nasogastric or nasoduodenal tube is the simplest technique for feeding patients who are unlikely to require tube feeding for more than 6 weeks. Gastrostomy, gastrojejunostomy and jejunostomy tubes placed by using endoscopic, radiologic, or surgical techniques should be considered in patients who require long-term feeding. With newer endoscopic feeding techniques replacing more conventional surgical techniques, this review proposes to discuss the newer developments in techniques of enteral feeding. RESULTS This review will briefly discuss the principles governing nasoenteral feeding and will describe in detail the endoscopic assisted methods for placing enteral feeding tubes. These include percutaneous endoscopic gastrostomy, jejunal extension through a percutaneous endoscopic gastrostomy or direct endoscopic jejunostomy. It will also discuss the procedural complications and long term results of these methods of enteral feeding. Lastly the latest innovation in enteral feed - the one step button - is also discussed. CONCLUSIONS Percutaneous endoscopic gastrostomy placement is an appropriate method for providing nutrition in ill patients if no contraindication to enteral feeding exists. In certain situations, percutaneous endoscopic gastrostomy placement may even be used to make the life of a terminally ill patient comfortable.

UI MeSH Term Description Entries
D009751 Nutritional Requirements The amounts of various substances in food needed by an organism to sustain healthy life. Dietary Requirements,Nutrition Requirements,Dietary Requirement,Nutrition Requirement,Nutritional Requirement,Requirement, Dietary,Requirement, Nutrition,Requirement, Nutritional,Requirements, Dietary,Requirements, Nutrition,Requirements, Nutritional
D010288 Parenteral Nutrition The administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered by a route other than the alimentary canal (e.g., intravenously, subcutaneously). Intravenous Feeding,Nutrition, Parenteral,Parenteral Feeding,Feeding, Intravenous,Feeding, Parenteral,Feedings, Intravenous,Feedings, Parenteral,Intravenous Feedings,Parenteral Feedings
D004750 Enteral Nutrition Nutritional support given via the alimentary canal or any route connected to the gastrointestinal system (i.e., the enteral route). This includes oral feeding, sip feeding, and tube feeding using nasogastric, gastrostomy, and jejunostomy tubes. Enteral Feeding,Force Feeding,Nutrition, Enteral,Tube Feeding,Gastric Feeding Tubes,Feeding Tube, Gastric,Feeding Tubes, Gastric,Feeding, Enteral,Feeding, Force,Feeding, Tube,Feedings, Force,Force Feedings,Gastric Feeding Tube,Tube, Gastric Feeding,Tubes, Gastric Feeding
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D017060 Patient Satisfaction The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial. Satisfaction, Patient

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