Feeding Tubes: The Basics

What is a feeding tube?

When you are unable to eat or absorb enough nutrients from food, you may need a feeding tube. You can receive nutrition (vitamins, nutrients, and calories), hydration, and medications through the feeding tube.

There are many different feeding tubes:

• Nasogastric tube (NG-tube, NGT): An NG-tube is a small thin tube, placed through the nose and throat and down into the stomach. NGTs are often used for short periods of time (4 weeks or less).
• Nasojejunal tube (NJT): This is like an NG-tube, except it passes through the stomach into one of the upper parts of the intestine, called the jejunum.
• Gastrostomy Tube (G-tube or peg tube): G-Tubes are surgically inserted directly into the stomach. G-tubes can be used in people with longer term feeding/nutrition needs.
• Gastrostomy-Jejunostomy or GJ-tube (Transgastric-Jejunal or TJ tube): The GJ-Tube is surgically inserted through the abdominal (belly) wall, into the stomach and down into the jejunum (intestine).
• Jejunostomy or J-tube: The J-tube is surgically inserted through the abdominal wall, directly into the jejunum, past the stomach.

Your care team will decide which tube is right for you based on your diagnosis, length of time you may need nutrition therapy, how well your stomach and intestines work, and your nutritional needs.

How are feedings given?

Once your feeding tube is placed, you will slowly start feeding through the tube until you reach your calorie/hydration goal. Tube feeds are started slowly to allow your body to adjust to the feeding, and to watch for:

• Gastroparesis (when the stomach is unable to empty food into the intestine).
• Aspiration (when contents from the stomach are coughed up or back up into the airway).
• Nausea or vomiting.

Tube feedings are given either through:

• A bolus: Formula is given with a syringe, directly into the feeding tube at regular times throughout the day.
• Continuous feeds: Formula is given through a pump over a fixed period (24 hours, 12 hours, or overnight) in a slower, more consistent manner than bolus feeds.

Your healthcare provider will tell you how to give medications through the tube. Be sure to tell your provider about any vitamins, supplements, or other medications you take. There are some medications that cannot go through the tube or that need a special formulation to do so.

Where do I get the feedings?

Your healthcare providers will work with your insurance and will let you know who will provide your tube feeding formula and supplies. This may be done through a durable medical equipment company (DME) or through a homecare/home infusion provider. You will likely have a home nurse who will teach you about feedings and watch your progress. Of note, for most insurance providers to cover tube feedings, those tube feedings must be your only source of nutritional intake. If you are able to eat and get nutrients by mouth, your insurance company may not cover the cost of your tube feedings.

If your insurance will not cover your formula, there may be patient assistance programs through the manufacturer. Your oncology social worker or navigator can help refer you to these programs. The Oley Foundation (http://oley.org/) is a non-profit organization that has a list of equipment and supplies that have been donated, as well as education, advocacy, and networking opportunities.

Resources for more information

The Oley Foundation: http://oley.org/

This organization strives to enrich the lives of patients dependent on home intravenous nutrition and tube feeding through education, advocacy, and networking.

Feeding Tube Awareness Foundation: http://www.feedingtubeawareness.org/

This organization was formed to support parents of children who are tube-fed but has lots of useful information for anyone who needs help with tube feedings.