Feeding tube
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A feeding tube is a medical device used to provide nutrition to patients who cannot obtain nutrition by swallowing. The state of being fed by a feeding tube is called enteral feeding or tube feeding. Placement may be temporary for the treatment of acute conditions or lifelong in the case of chronic disabilities. Many patients treated using a feeding tube lack the ability to survive on their own without such technology.
A variety of feeding tubes are used in medical practice. They are usually made of polyurethane or silicone. The diameter of a feeding tube is measured in French units (each French unit equals 0.33 millimeters). They are classified by site of insertion and intended use.
Feeding tubes may be used for the force-feeding of prisoners on hunger strike, a controversial use often categorized as torture. [1] The World Medical Association prohibits the involuntary force-feeding of hunger strikers (except in cases of coma or mental impairment) through the Declaration of Tokyo (1975) and the Declaration on Hunger Strikers (1991).
Feeding tubes are also used for the force-feeding of animals, such as the ducks and geese used to produce foie gras.
Nasogastric tube
A nasogastric tube (NG tube) is a tube, inserted into a nostril of the nose, into the throat, down the esophagus and into the stomach. It is suitable only for relatively short-term use, as it is uncomfortable and tends to be removed by the patient. It is used for nasogastric suction (for intestinal decompression), and for administration of medications to those unable to swallow. A slightly more flexible and thinner version is typically used for enteral feedings and hydration in patients who either cannot eat, or who have swallowing difficulties that would result in pneumonia if they were permitted to attempt to eat. Nasogastric tubes are the type used for the force-feeding of prisoners.
Swallowing difficulties are often casued by cerebrovascular accident (stroke), can also be due to obstruction as a result of growths such as tumors in the mouth, throat or esophagus.
Esophagostomy tube
The esophagostomy tube is inserted through an incision in the side of the neck into the esophagus and threaded into the stomach. It is rarely used in humans, but is commonly used in veterinary practice to feed animals with jaw injuries that prevent chewing.
Gastric feeding tube
A gastric feeding tube, or "G-tube", is a tube inserted through a small incision in the abdomen into the stomach and is used for long-term enteral nutrition. The most common type is the percutaneous endoscopic gastrostomy (PEG) tube. It is placed endoscopically: the patient is sedated, and an endoscope is passed through the mouth and esophagus into the stomach. The position of the endoscope can be visualized on the outside of the patient's abdomen because it contains a powerful light source. A needle is inserted through the abdomen, visualized within the stomach by the endoscope, and a suture passed through the needle is grasped by the endoscope and pulled up through the esophagus. The suture is then tied to the end PEG tube that will be external, and pulled back down through the esophagus, stomach, and out through abdominal wall. The insertion takes about 20 minutes. The tube is also occasionally placed surgically. After the insertion, the abdominal wound must be covered with sterile dressings until it is healed (about a week). The tube is kept within the stomach by a balloon on its tip (which can be deflated to remove the tube). Gastric tubes are suitable for long-term use: they last about six months, and can be replaced through an existing passage without an additional endoscopic procedure. The G-tube is useful where there is difficulty with swallowing because of neurologic or anatomic disorders (stroke, esophageal atresia, tracheoesophageal fistula), and to avoid the risk of aspiration pneumonia. It is also used when patients are malnourished and cannot take enough food by mouth to maintain their weight. They are also useful in reverse.
Jejunostomy tube
A jejunostomy tube is similar to a gastric tube, though generally has a finer bore and smaller diameter, and is surgically inserted into the jejunum rather than the stomach. They are used when the upper gastrointestinal tract must be bypassed completely, and can be used as soon as 12 hours after surgery.
Feeding through these tubes are generally commercially prepared to provide adequate nutrition and to not result in clogging when used with a pump or with drip feedings.
Withdrawal
Tube feeding, like all medical treatments, can be declined or withdrawn, especially in the setting of a terminal illness where its use would not alter the ultimate outcome. Actively withdrawing an existing feeding tube is considered by some to be a form of active euthanasia, while deciding not to place one could be considered passive euthanasia.