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Indications & Contraindications for Enteral Nutrition

Instructor: Amy Albert

Amy is a Physician Assistant and certified professional coder. She holds a masters degree and has taught at the graduate school level.

Enteral nutrition is feeding by means of the gastrointestinal (GI) tract. Enteral feeding includes normal oral diet, liquid supplements and tube feeding. This lesson will discuss the indications and contraindications for enteral nutrition.

What Is Enteral Nutrition?

How many times have you thought to yourself that your hunger is so intense that you would eat anything? Most people take the process of eating for granted. When you are hungry, you chew and swallow your food. Food travels down the throat, through the esophagus and into the stomach where digestion begins. From the stomach, the food travels into the small and large intestine. Here nutrients are absorbed through the gut and enter your bloodstream. But what happens if you are unable to chew and swallow, or perhaps too sick to eat ? You may find yourself needing enteral nutrition.

Enteral nutrition is feeding by means of the gastrointestinal (GI) tract. Normal oral intake of food is enteral nutrition. Liquid supplements , such as Ensure, are also enteral nutrition. For this lesson, enteral nutrition will be synonymous with tube feeding. Tube feeding is a diet that is supplied through a tube directly into the GI tract. The tube can be placed through the nose or through the skin to access the GI tract. For example, a nasogastric tube provides feeding with a tube that is inserted into the nose and placed down into the stomach. Another example of tube feeding, is through a PEG tube. A PEG tube provides nutrition through a surgically created opening in the skin. From here, the PEG tube is placed directly into the stomach or small intestine. In tube feeding, the nutrition provided is a liquid that is a mixture of carbohydrates, proteins, vitamins, fats and fluids.

Uses for Enteral Nutrition

Enteral nutrition is used whenever a person can not get proper nutrition through oral intake. For example, someone who is unable to chew and swallow will need enteral nutrition. This could be because the patient has no appetite and is not eating. Or perhaps the patient has a motility disorder of the esophagus and is unable to swallow. Enteral nutrition is also needed if a patient has an obstruction in the throat or stomach. Commonly an obstruction arises from a tumor. Enteral nutrition is also commonly used if the GI tract is unable to absorb the nutrients from food digested. This is often seen in diseases such as Crohn's disease and ulcerative colitis. Lastly, enteral nutrition may be needed if a person had a stroke, is on a ventilator or is in a coma.

Types of Enteral Nutrition

It is relatively simple to choose which type of enteral nutrition to use. After four to five days of inadequate food intake, enteral nutrition is started. If the patient needs enteral nutrition for less than four weeks, a nasogastric tube is used. If the patient will need feeding for more than four weeks, then a percutaneous feeding tube is placed through the skin. This is a PEG tube. Enteral nutrition is continued for as long as necessary and can be done at home with the help of a caregiver.

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