An Overview of Tube Feeding in Clinical Practice

Tube Feeding (Gavage): An Overview Meeting the nutritional needs of patients plays a crucial role in accelerating their recovery. Unfortunately, some patients are unable to swallow food due to certain medical conditions and cannot eat orally. For these patients, an alternative method known as “tube feeding” or “enteral nutrition” is employed to deliver essential nutrients directly to the gastrointestinal tract. The nutrient solution administered through the tube is referred to as “gavage,” which serves as the patient’s source of nutrition. This article provides an introduction to tube feeding and discusses suitable formulas for gavage. What is Tube Feeding? Tube feeding, or enteral nutrition (EN), is a method by which nutritional substances and fluids are delivered to a patient’s gastrointestinal tract via a specialized tube. Patients who lack the ability to swallow or eat orally receive their nutrition through this method, utilizing parts of the digestive system such as the esophagus, stomach, or intestines to supply necessary nutrients and maintain gastrointestinal function. Who Requires Tube Feeding? Tube feeding is indicated when a patient is physically unable to eat by mouth or cannot consume sufficient food orally, placing them at risk of severe malnutrition, weight loss, and muscle wasting. In such cases, a healthcare provider prescribes tube feeding to ensure adequate nutrition. Common conditions necessitating gavage include: Neurological disorders impairing swallowing Acute stages of AIDS Traumatic injuries to the brain, face, or esophagus Respiratory diseases and cystic fibrosis resulting in loss of swallowing ability Inability to consume adequate oral intake (e.g., severe hyperemesis gravidarum in pregnancy) Hypermetabolic states such as severe burns Anorexia secondary to congestive heart failure or cancer Facial surgery and spinal cord injuries Patients suffering from protein-energy malnutrition or growth failure Methods of Tube Feeding The choice of tube feeding method depends on the patient’s ability to digest and absorb nutrients and the expected duration of enteral nutrition therapy. Common tube feeding methods include: Nasogastric Tube (NGT): The tube is inserted through the nose into the stomach. Orogastric Tube (OGT): The tube is inserted through the mouth into the stomach. Nasojejunal Tube: The tube is inserted through the nose into the small intestine (jejunum). Orojejunal Tube: The tube is inserted through the mouth into the small intestine. Gastrostomy Tube: Used for long-term feeding or when nasal and esophageal access is not feasible. A small opening (stoma) is surgically created in the abdominal wall to access the stomach, allowing direct tube insertion. A similar less invasive procedure