Enteral feeds are supplied into the digestive tract (stomach or jejunum) and therefore the normal mechanisms that are triggered within the tract when eating will also occur in during feeding. The feeling of satiety is the result of distension in the stomach and intestine, due to the presence of food and therefore this mechanism remains in place and results in a “full feeling” Due to the by-passing of the mouth and therefore the chewing action, specific hormones that are released during mastication are also by-passed and this can slow down the speed at which things move through the digestive tract. This slowing can result in feelings of bloating, diarrhoea, nausea and cramping. Should you encounter these sensations, talk to your nutrition team as there are medications and techniques which can improve things.
Yes, you will not be allowed home until the team are sure that you are fully able to cope and aware of everything that you need to know and are confident that you can do it without incident. Often those you live with, or care for you are trained in the same way and therefore you have someone to back up the procedures at home. You will be monitored in the community often by a multi-disciplinary team, including a dietetian, district nurse (often a specialist in enteral nutrition) and your GP. Each will have a specific role involving your care and you will be made aware of these and given information on who to contact when and how.
This is a rare condition of PEG tubes where the internal fixation device around the tube migrates between the stomach wall and the skin. The result is that new cells grow around the end of the tube and a fistula (cavity) which is mucus filled grows outside the stomach. This fistula can leak or even burst resulting in the contents entering the body and causing sepsis. This is a serious condition and requires urgent medical intervention, but it is extremely rare that it gets to this stage. With regular check-ups your child's nutrition team will ensure that the risk of buried bumper syndrome is minimal, but in the event it does occur, it is likely to be recognized early and can be corrected with an endoscopic procedure and possibly without the removal of the tube. The evidence suggests that when the tube is fixed by a saline inflated balloon, the risk of Buried Bumper Syndrome is further reduced as the surface area of the fixation device is far greater, preventing burying.
As the name suggests it is a set on conditions that arise when a malnourished person begins to receive regular nutrition and this is of a greater risk when the nutrition is given via parenteral or enteral methods. This is because as the refeeding occurs there is a high demand for particular nutrients and chemicals, which typical feeds are not able to meet. This failure to meet demand can result in swelling of the ankles, legs and around the heart muscle; increasing the effort required to maintain a regular blood pressure. Furthermore, the potential for severe hypoglycaemia is far greater, which if untreated can result in coma or death.
NO, people on enteral feeding have the advantage of being able to pause and disconnect their feeds once it is started. Although this is not advised and should be kept to a minimum it is safe to do so, if necessary, such as getting ready in the morning, before the feed is completed. With advances in medical equipment this is not often required as many of the feeding pumps and equipment are small and portable and therefore you can continue to get on with normal activities during feeding.
It is important that you are receiving the best feed for your needs and you may find that as your treatment continues your requirements may change. It is important to ensure that you are getting the appropriate mix of nutrients and therefore regular blood test will help to determine whether your needs are being met and provide an indication as to how your body is maintaining its internal balance. Anyone on Enteral nutrition, particularly if you are very underweight or malnourished are at risk of “refeeding syndrome” and regular blood tests can pick up on this in its early stages, before serious complications arise.
YES, it may seem strange to think that your child can still get food poisoning when they do not eat food, but essentially food poisoning is when unfriendly and harmful bacteria are able to enter the gastrointestinal tract (GI). Because these bacteria need a supply of nutrients we find them on foods and when we eat such foods we allow them to enter the GI tract. The feed is basically a liquid form of all these nutrients providing a perfect medium for bacterial growth. Without good hygiene during tube feeding, contamination with bacteria could cause food poisoning. Your hospital will teach you how to prevent this happening.
Good hygiene is essential during tube feeding, because any contamination with bacteria could cause food poisoning. Your hospital will teach you how to prevent this happening.