Managing Home Tube Feedings

If you’re unable to get the nutrition you need through food and beverages, your health care team may recommend tube feeding, also known as enteral nutrition.

What Is Enteral Nutrition?

When people need enteral nutrition (EN) for a short period of time, a tube is placed through the nose to the stomach or small intestine. People who need tube feeding for a longer period have a tube surgically placed.

If you are on long-term enteral nutrition, it’s important to meet regularly with a registered dietitian nutritionist (RDN) to ensure you're getting the nutrition you need. Your health care team also can help troubleshoot issues with your EN routine.

Who Might Need Enteral Nutrition?

Tube feeding can be beneficial in a variety of situations, including:

• Difficulty chewing or swallowing food
• Head, neck or oral cancer
• Severe gastrointestinal disease
• Eating disorders

Every situation is unique. An RDN can help determine if you are able to meet your nutrition needs by mouth or if you might benefit from EN support.

Goals for Enteral Nutrition Support at Home

Enteral nutrition should:

• Provide appropriate calories, nutrients and fluids to maintain body weight, muscle mass and hydration
• Deliver enough vitamins and minerals
• Be well-tolerated, with minimal side effects

If you have new or ongoing challenges with your home EN, it is essential you talk with your care team.

Gastrointestinal (GI) Distress with Tube Feeding

GI distress is common for people on enteral nutrition. Examples may include stomach bloating, diarrhea, constipation, gas, nausea, vomiting or reflux. These symptoms can make it hard to follow your EN routine or meet your nutrition goals.

Tips for managing these symptoms include changes to:

• Medications
• How fast the formula is delivered
• The type of EN formula you use

In some cases, your health care provider may need to change where your tube is placed or how the formula is going into your body.

Tube Challenges and Troubleshooting

A common home EN concern is when a tube clogs. Use these tips:

• Let your care team know if your tube is being used for anything other than formula, water and medications.
• Follow the amount and frequency of water flushes that were prescribed.
• Create a plan with your care team for what to do if you get a tube clog.

Other possible EN complications include skin irritation, tube leakage, tube dislodgement (when the tube comes out), aspiration (when something other than air enters the lungs), and gastrointestinal bleeding. These can be serious complications. Discuss with your healthcare team as soon as possible if you have:

• Ongoing vomiting or dry heaving
• Fever, shortness of breath or chest pain
• Ongoing diarrhea or bloody stools
• Extreme stomach pain with feedings
• Foul smelling odor or leakage from your tube or around your tube
• Tube easily moving in and out of the opening in the body

Where to Turn for Support

If you’re on enteral nutrition at home, a support system of family, friends and your healthcare team can be helpful. Home nutrition support organizations such as the Oley Foundation also offer peer groups and other resources.

This article has been reviewed by Dietitians in Nutrition Support (DNS), a dietetic practice group of the Academy of Nutrition and Dietetics.