Tube Feeding: Living With a Feeding Tube

Tube feeding is also called artificial feeding or enteral nutrition. It supplies nutrition and liquids when you're unable to eat or drink. It's done by surgically inserting a tube into the stomach. The surgery is called percutaneous endoscopic gastrostomy (PEG). The tube is called a G-tube or PEG tube.

During PEG, the doctor makes a small cut (incision) in your belly. Then he or she puts the feeding tube into your mouth and guides it down your throat and into your stomach. One end of the tube is pulled out of your belly through the incision. This end of the tube will stay outside your body. The other end will stay in your stomach.

You'll have about 6 to 12 inches of tubing outside your body. The tube is about the same width as a pen.

Instead of a G-tube, you may instead get a tube that's placed in the first part of the small intestine. This is called a jejunostomy tube or J-tube.

Tubes last about 1 year. If the tube needs to be replaced, the doctor will do it.

Tube feeding choices

There are a few different ways to do tube feedings. Your doctor will help you decide which is best for you and how often feedings should occur. Your options include:

• A feeding syringe. This is most common. A syringe is connected to the tube. Formula is put into the syringe and flows into the tube and your stomach. This is called bolus feeding.
• A gravity bag. Formula is placed into a special bag that is hung on a hook or a pole. The height and weight of the bag make the food flow down the tube and into your stomach.
• A bag and pump. A pump is used to push formula from a bag through the tube. This is also called continuous feeding.

When you first get a feeding tube, your doctor may suggest that you have a nurse or dietitian visit you at home to get you started. At first you may need a friend or family member to help you with your tube feedings. But with practice, you may be able to do it yourself.

Continue to Why?

Everything about a feeding tube can seem scary: the surgery itself, dealing with a tube coming out of your body, not being able to eat the way you used to. These are huge changes—there's no getting around it.

Your biggest challenge may be your new relationship with food. For many people, eating and savoring food is one of the most pleasing parts of daily life. You may grieve the loss of the daily habit of eating and the social aspects of sharing food with others.

If you've struggled to get enough nutrition—if it's been too hard to eat or swallow—having a feeding tube can help you regain your health and strength. And understanding how a feeding tube works is a first step toward dealing with these changes. It can also help you avoid common problems that can occur.

Continue to How?

Using the tube for feeding

It's important that the food you use for tube feeding have the right blend of nutrients for you. And the food needs to be the correct thickness so the tube doesn't clog. For most people, a milk shake type of formula that you can buy in a can works best for tube feeding. Your doctor or dietitian will help you find the right formula to use.

• Make sure that the tube-feeding formula is at room temperature.
• Wash your hands before you handle the tube and formula. Wash the top of the can of formula before you open it.
• Follow your doctor's instructions for how much formula to use for each feeding.
  • If using a feeding syringe: Connect the syringe to the tube, and put the formula into the syringe. Hold the syringe up high so the formula flows into the tube. Use the plunger on the syringe to gently push any remaining formula into the tube.
  • If using a gravity bag: Connect the bag to the tube, and add the formula to the bag. Hang the bag on a hook or pole about 18 inches above the stomach. Depending on the type of formula, the food may take a few hours to flow through the tube. Ask your doctor what you can expect and how long it should take.
• Sit up or keep your head up during the feeding and for 30 minutes after.
• Keep the formula in the refrigerator after you open it. Don't let the formula sit at room temperature for more than 8 hours. Throw away any open cans of food after 24 hours, even if they have been refrigerated.
• If you feel sick to your stomach or have stomach cramps during the feeding, slow the rate that the formula comes through the tube. Then slowly increase the rate as you can manage it.
• Talk with your doctor about changing your feedings or medicines if you are having problems with diarrhea, constipation, or vomiting.

Using the tube to take medicines

• If you take medicines through your feeding tube, follow your doctor's instructions. Don't try to put whole pills in the tube—they may get stuck. Ask your doctor if liquid medicine is available, or if your pills can be crushed.
• Don't mix your medicine with the tube-feeding formula. This can cause a clog in the feeding tube.
• Don't put more than one medicine down your feeding tube at a time.
• Flush the tube with water before and after you put each medicine down your tube.

Caring for the tube

• Keep it clean. That's the most important thing you need to know about caring for your tube. Flush the tube with warm water before and after feedings or giving medicines. You can use a syringe to push water through the tube. Clean the end (opening) of the tube every day with an antiseptic wipe.
• Always wash your hands before touching the tube.
• Tape the tube to your body so the end is facing up. Look for medical tape in your local drugstore. It may irritate your skin less than other types of tape. Change the position of the tape every few days.
• Clamp the tube when you're not using it. Put the clamp closer to your body so that food and liquids don't run down the tube.
• Keep the skin around the tube clean and dry.
• Sleep on your back or your side. You are likely to be more comfortable.

Avoiding common problems

• Blocked tube. A blocked tube can happen when the tube isn't flushed or when formula or medicines are too thick.
  • Prevent blockage by flushing the tube with warm water before and after feedings and medicines.
  • If the tube is blocked, try to clear it by flushing the tube. Call your doctor if the tube won't clear.
  • Don't use a wire or anything else to try to unclog a tube. A wire can poke a hole in the tube.
• Tube falls out. Don't try to put the tube back in by yourself. Call your doctor right away. The tube needs to be replaced before the opening in your belly closes. This can happen within hours.
• Leaking tube. A tube that leaks may be blocked, or it may not fit right. After checking the tube and flushing it to make sure that the tube isn't blocked, call your doctor.

Continue to Where?

Now that you have read this information, you are ready to use a feeding tube.

Talk with your doctor

If you have questions about this information, take it with you when you visit your doctor. You may want to mark areas or make notes in the margins where you have questions.

A support group may help you cope. You can share your feelings and challenges. Ask your doctor about groups or other resources in your area.

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