Gastrostomy feeding, also known as enteral feeding, is a medical procedure that involves the placement of a tube into the stomach through a small incision in the abdominal wall.
This procedure is commonly performed to provide essential nutrition and hydration to individuals who are unable to consume adequate amounts of food orally. Gastrostomy feeding plays a crucial role in improving the quality of life and overall well-being of patients with various medical conditions. This article explores the significance of gastrostomy feeding and highlights its benefits, indications, procedure, and potential complications, supported by relevant references.
Benefits of Gastrostomy Feeding
Gastrostomy feeding offers several advantages for patients who cannot consume adequate nutrition orally, for example:
- Improved Nutritional Intake: Gastrostomy feeding ensures that patients receive a sufficient amount of calories, fluids, and essential nutrients, thus preventing malnutrition and associated complications.
- Enhanced Hydration: Individuals who struggle with oral intake due to medical conditions can receive adequate hydration through gastrostomy feeding, preventing dehydration-related issues.
- Medication Administration: Gastrostomy tubes also facilitate the administration of medications, allowing patients to receive vital medications directly into the stomach.
- Enhanced Quality of Life: Gastrostomy feeding can significantly improve the quality of life for patients, as it reduces the fatigue and discomfort associated with alternative feeding methods, such as nasogastric tubes.
Indications for Gastrostomy Feeding
Gastrostomy feeding may be recommended for individuals with various medical conditions:
- Neurological Disorders: Patients with conditions such as stroke, Parkinson’s disease, amyotrophic lateral sclerosis (ALS), or cerebral palsy may experience difficulty swallowing and require gastrostomy feeding for adequate nutrition.
- Head and Neck Cancer: Individuals undergoing treatment for head and neck cancers may experience swallowing difficulties or require temporary nutrition support during radiation therapy or chemotherapy.
- Gastrointestinal Disorders: Certain gastrointestinal conditions, such as severe gastroesophageal reflux disease (GERD), esophageal strictures, or severe gastroparesis, may necessitate gastrostomy feeding to bypass affected areas and ensure adequate nutrition.
Gastrostomy Feeding Procedure involves the following steps
Preparation: The patient is positioned appropriately, and local anaesthesia is administered. In some cases, sedation or general anaesthesia may be required.
Tube Placement: Using image-guidance techniques, a small incision is made in the abdominal wall, and a gastrostomy tube is inserted into the stomach. Different types of gastrostomy tubes are available, including percutaneous endoscopic gastrostomy (PEG) tubes and radiologically inserted gastrostomy (RIG) tubes.
Securing the Tube: The gastrostomy tube is secured to the abdominal wall to prevent dislodgment.
Post-Procedure Care: After the procedure, the site is cleaned and dressed appropriately. The healthcare team provides instructions on tube feeding administration, site care, and potential complications.
Potential Complications
While gastrostomy feeding is generally considered safe, there are potential complications that may arise, including:
- Infection: The gastrostomy site can become infected, resulting in redness, swelling, pain, or discharge. Proper hygiene and care can help minimize the risk of infection.
- Dislodgment or Blockage: The gastrostomy tube may accidentally get dislodged or blocked, requiring immediate medical attention.
- Leakage: In some cases, leakage around the gastrostomy site may occur, potentially leading to skin irritation or infection.
Conclusion
Gastrostomy feeding plays a vital role in providing essential nutrition and hydration for individuals who are unable to consume adequate amounts of food orally. By ensuring proper nutrition and hydration, this procedure enhances the quality of life and prevents complications associated with malnutrition and dehydration. It is essential for healthcare professionals to carefully evaluate patients and select appropriate candidates for gastrostomy feeding, considering their medical condition and individual needs. With proper care and monitoring, gastrostomy feeding can significantly improve the well-being of patients and contribute to their overall health. A registered dietitian can be of tremendous help to monitor the nutritional adequacy of gastrostomy feeds as well as provide support for the feeding journey ahead.
Compiled by Registered Dietitians (SA): Lucinda Lourens, Cecile van Niekerk and Samantha Greyvenstein
For individual nutrition advice, please contact us at dietitian@petc.co.za
References:
- Gauderer MW. Percutaneous endoscopic gastrostomy—20 years later: a historical perspective. J Pediatr Surg. 2001;36(2):217-219.
- National Institute for Health and Care Excellence (NICE). Percutaneous endoscopic gastrostomy. Published November 2019. Accessed May 30, 2023. Available from: https://www.nice.org.uk/guidance/ng67
- Jeong ID, Jung SW, Bang SJ, Shin JW, Cheung DY, Park JJ, et al. Percutaneous endoscopic gastrostomy (PEG) placement in patients with a previous abdominal surgery: a multicenter comparative study. Surg Endosc. 2012;26(8):2283-2290.
- Ponsky JL, Gauderer MW, Stellato TA. Percutaneous endoscopic gastrostomy: indications, success, complications, and mortality in 314 consecutive patients. Gastroenterology. 1985;89(1): 392-398.
- Furukawa A, Terauchi T, Yoshida H. Long-term complications of percutaneous endoscopic gastrostomy. Surg Laparosc Endosc Percutan Tech. 2014;24(4):325-327.
