Understanding Peg Tubes or Feeding Tubes

The problem is not always that a person is unable to tolerate eating. Sometimes people just stop eating. It could be due to a brain injury, or a refusal to eat. I see this mostly in elderly patients. It seems that most people stop eating as they approach the end of life. Their bodys do not require as much energy and a person can last quite a while on iv fluids alone. Some family choose to provide nutrition in these cases.

A feeding tube or Peg Tube is not always a long term intervention. Sometimes a person only needs feeding assistance for a short amount of time. A Nasogastric Tube can easily be used short term or a surgically placed Peg Tube can be removed later.

TPN or parental nutrition means the GI tract does not have adequate function. TEN or entral nutrition means the intestines absorb easily but ingestion is impaired.

Nasogastric Tube or Dobhoff

In easy to understand terms a nasogastric tube is measured from the patients mouth, to ear, and to the stomach. The patient is sitting up and the tube is advanced through the nostril to the stomach stopping at the measured length. The tube is taped into place across the nose. This sounds very easy but the patient often fights or resist the tubing. If the person is able to swallow a small sip of water this sometimes helps the tube go down. A portable chest xray is used to confirm placement. Placement has to be confirmed before feedings can be started. For long term feeding a person may have a NG Tube until surgical placement is done, but not permanently.

Peg Tube

A peg tube is different as it is surgically placed and more permanent. A tube is placed through the abdominal wall for feeding and medication purposes. It is important that the peg tube is maintained and well cared for. Sometimes the skin around the peg tube may get excoriated. Generally 24 hours after placement the area surrounding the peg can be cleaned with normal saline. Dressings should be kept clean and dry around the site.

Continuous Feeding