March 30, 2023

What is enteral nutrition?

With enteral nutrition, patients who cannot, do not want to or are not allowed to take food orally on their own are fed a nutritional pulp via a tube. A number of physical and psychological illnesses, but also signs of old age and operations can be the reasons for the use of artificial nutrition. In the case of artificial nutrition, a distinction is made between enteral and parenteral nutrition. Enteral nutrition means that the patient is fed by means of a tube via the digestive tract, i.e. via the gastrointestinal tract.

Parenteral nutrition, on the other hand, bypasses the digestive tract and runs directly into the bloodstream via an infusion. This procedure is often used when the patient could not be fed orally or through a stomach tube for a period of more than three days. This can be the case, for example, in acute gastrointestinal diseases or digestive and absorption disorders in the small intestine. There are two ways to perform enteral nutrition.

With the use of a transnasal probe, a tube is pushed through the nose and the esophagus into the stomach or even up to the small intestine. This method is only suitable as a temporary measure. The advantages of this method that it is less invasive. No damage is left to the body. Patients, however, often perceive the transnasal tube as unpleasant and disturbing. This can go so far that the tube is pulled by the patient intentionally or accidentally. Another common problem is the formation of pressure ulcers in the nose.

In a percutaneous endoscopic gastrostomy, or PEG for short, a tube is inserted through the abdominal wall into the stomach from the outside with the aid of an endoscope. To prevent the tube from slipping, it is fixed in place with an outer and an inner retaining plate. Since the insertion of a percutaneous tube is considerably more complex than a transnasal tube, it is mainly used for long-term artificial feeding. The advantages of this method are that the tube is not immediately visible and the nose, esophagus and stomach are spared.

There are many different reasons for the necessity of enteral nutrition. For example, an operation on the esophagus may require the insertion of a feeding tube. Tumor diseases of the entire digestive tract, swallowing difficulties or anorexia are other possible reasons.

Important for artificial nutrition is the consent of the person concerned. No one may be artificially fed against their will. If the patient himself is not able to express his wish, the decision-making power lies with his legal representative. However, even in this case, the presumed will of the patient must be taken into account when making the decision.