Various medical conditions and disorders can affect a person’s ability to consume and digest food naturally. In this case, alternative feeding methods, such as enteral nutrition, have to be utilized. But what exactly is enteral nutrition? When is it used, and what are some of the main types of enteral nutrition formulas that may be given to a patient? Read on for a full, in-depth guide to enteral nutrition.

Definition of Enteral Nutrition

We’ll begin with a definition. What is enteral nutrition? Enteral nutrition, which may also be known as enteral administration, enteral feeding, or tube feeding, is a type of feeding in which food is passed into the body via a feeding tube. Typically, the feeding tube will pass all the way down to the stomach or small intestine, delivering liquid food into the core of the digestive system.

The main distinctive feature of enteral nutrition as opposed to other forms of feeding, like parenteral nutrition, is that enteral nutrition makes use of the body’s regular digestive organs and gastrointestinal (GI) tract. This method can therefore be used for patients who may be unable to eat foods by mouth for some reason, but still have functional digestive organs, like the stomach and intestines.

Why Would a Patient Need Enteral Nutrition?

There are many reasons why a patient might need to be given enteral nutrition. As stated above, this process is typically used when a patient has a functional digestive system but isn’t capable of consuming enough food to meet their body’s needs. This might be because of a disease, a mental condition, or a physical condition that makes it hard or painful to eat and swallow solid foods. Here are some situations in which patients may be given enteral nutrition:

• Stroke – After having a stroke, a patient may find it difficult to eat and swallow foods. 
• Cancer – Cancer and cancer treatment can cause various symptoms that make it hard for patients to eat, like tiredness, nausea, and a lack of appetite. 
• Injuries – Certain injuries, especially around the face and neck, may make it hard for patients to chew and swallow food normally. 
• Illness – Certain illnesses affecting the throat or other parts of the body could make it difficult for patients to swallow food.
• Failure to Thrive – Failure to thrive is the medical term when infants are unable to consume enough food to gain sufficient amounts of weight for their age. 
• Neurological Disorders – Various neurological disorders can cause a patient to have higher-than-average caloric requirements, but may also make it harder for the patient to eat food normally.

What Are the Different Types of Enteral Feeding?

There are several different types of enteral feeding tubes that may be used for enteral nutrition. The tubes can enter the body in different locations and feed liquid food through to different organs, like the stomach or intestines. The right type of tube will vary from patient to patient, and it’s important for doctors to select the appropriate type and size of enteral feeding tube to suit each situation:

1. Nasogastric or NG Tube – A nasogastric tube, commonly referred to as an NG tube, is one that enters the body via the nose and passes all the way through to the patient’s stomach.

2. Orogastric Tube – An orogastric tube, or OG tube, is one that enters the body via the mouth and passes through to the stomach.

3. Nasoenteric Tube – A nasoenteric tube enters the body via the nose and passes through to the intestines. There are multiple types of nasoenteric tubes, including nasojejunal and nasoduodenal varieties.

4. Gastrostomy Tube – Gastrostomy tubes are inserted through the skin of the abdomen, feeding directly through into the stomach without actually passing via the esophagus.

5. Oroenteric Tube – An oroenteric tube is one that passes via the mouth through to the intestines.

6. Jejunostomy Tube – A jejunostomy tube is used in patients who have had some sort of stomach or esophageal surgery, and it passes through the skin of the abdomen into the intestines.

The insertion procedures for each type of enteral nutrition tube can vary. Some of them are relatively quick and simple to insert, but others require additional procedures and the use of anesthetic.

It’s also worth noting and understanding the difference between the three main methods of enteral nutrition:

1. Pump – Pump feeding, or continuous feeding, is when the enteral feeding tube is connected to a pump that continuously delivers the nutritional formulas at a set speed. 
2. Bolus – Bolus feeding is when the patient receives the liquid food in small, controlled doses, via a syringe. This method does not require the use of a pump. 
3. Gravity – The gravity method involves the enteral food formula passing from a bag or bottle through the feeding tube via gravity.

What Are the Different Types of Enteral Nutrition Formulas?

As well as having different types of feeding and feeding tubes, there are also various enteral nutrition formulas for medical personnel to be aware of. Each formula is different, with its own set of nutrients and best-use scenarios. Here are some brief descriptions of the three main kinds of enteral nutrition formulas:

• Standard – Standard formulas, also known as whole-protein formulas, are made up of all the necessary nutrients for good health. They can be used for enteral feeding in both adults and children and may also contain added ingredients like extra fiber, if needed.
• Peptide – Peptide or semi-elemental enteral nutrition formulas are also made up of all the essential nutrients that the body needs. However, the key feature of this kind of formula is that the long-chain proteins are broken down beforehand to make digestion easier.
• Specialized – There are also specialized formulas that can contain various nutrients to suit patients with specific dietary needs. A patient with diabetes, for example, might require a special kind of formula that is high in vitamins and minerals but low in carbs and sugars.

What Are the Benefits of Enteral Nutrition?

There are many benefits associated with enteral nutrition, including:

1. Relatively Affordable – A good benefit of enteral nutrition from the perspective of hospitals and healthcare providers is that the various supplies required are relatively cheap.

2. Simple – Another advantage of enteral nutrition is that it’s much simpler and less invasive than other methods, such as parenteral nutrition, as it doesn’t require any kind of surgery or penetration of the skin, in most cases. 

3. Fewer Complications than Parenteral – When compared to parenteral nutrition, enteral nutrition is generally regarded as a safer choice, with fewer risks, complications, and side effects for patients to worry about.

4. Efficient Use of Nutrients – With enteral nutrition, the nutrients that are transferred into the body are more efficiently used and absorbed into the system than those in parenteral formulas.

5. Stimulates Blood Flow in the Digestive System – Another advantage of enteral nutrition is that it keeps the digestive organs working. This means that there’s a healthy bloodflow around the digestive organs, like the stomach and intestines.

6. Prevents Atrophy – Since enteral nutrition stimulates and relies upon the body’s digestive organs, it keeps them working, which, in turn, helps to reduce the risk of any atrophy of the digestive organs or surrounding muscles.

What Are the Potential Risks or Complications of Enteral Nutrition?

Despite the benefits, enteral nutrition also has some risks and potential complications, such as:

1. Digestive Complications – One of the most common complaints in patients who undergo enteral nutrition is that they suffer from digestive difficulties, which can result in stomach aches and cramps.

2. Vomiting – The insertion process of the feeding tube into a patient’s throat can be a painful and uncomfortable one, and it may provoke feelings of nausea or vomiting reactions.

3. Constipation – Some patients also report that they suffer from constipation on a regular basis after undergoing enteral nutrition, as the body’s digestive organs can respond in unusual ways to this form of feeding.  

4. Diarrhea – Conversely, while some patients struggle with constipation during enteral nutrition, others complain of diarrhea.

5. Abdominal Distension – If a patient’s body reacts badly to the presence of a feeding tube, one of the most unpleasant side effects of the process is abdominal distension, which is when the abdomen swells much larger than normal.

6. Obstruction – There’s also a risk of gastrointestinal obstruction in patients who are undergoing enteral nutrition. The concentration and type of feeding formula needs to be carefully monitored and controlled and proper gastric venting is needed to allow gasses to escape.

7. Aspiration – Another risk factor is aspiration, which is when food or liquid is inhaled into the lungs, rather than flowing down through the esophagus and into the stomach.

8. Discomfort – In general, patients may feel quite uncomfortable with a feeding tube entering their mouth or nose, and the tube may cause irritation and generally unpleasant sensations.

9. Infections – If the feeding tube is not kept clean, there’s also a risk that it can introduce microbes into the body, which may lead to an infection.

Necessary Supplies for Enteral Nutrition

In order to carry out enteral nutrition, certain supplies may be required. This includes:

1. Feeding Tube – The tube is the most important part of the system, as it serves as a conduct for food to flow through.

2. Feeding Pump – Used for pump feeding, a pump controls the flow rate of food as it travels through the tube.

3. Enteral Formula – The feeding formula itself is another key component, and various kinds of nutritional formulas may be used.

4. Bags – Bags or bottles are also used to store the feeding formula before it passes into the body.

5. Accessories – Other accessories, like clips, tape, and rails may be used during enteral feeding to hold the tube and bag in the correct position. 

Where Can I Buy Enteral Nutrition Supplies?

If you’re looking to buy high quality enteral nutrition supplies from leading brands, choose CIA Medical. CIA Medical is one of the world’s leading suppliers of wholesale medical goods, with an extensive selection of enteral feeding essentials like tubes, syringes, and bags from industry-leading brands like Acta Medical, Utah Medical, Kentec Medical, Avanos Medical, and Baxter.

Frequently Asked Questions

What Is the Difference Between Parenteral and Enteral Nutrition? 

The main difference between enteral and parenteral nutrition is that enteral involves a feeding tube transferring liquid food into the digestive system, like the intestines and stomach, whereas parenteral feeding is when liquid nutrients are passed directly into the bloodstream via a catheter.

Is Enteral Nutrition Better Than Parenteral Nutrition? 

In some ways, yes, enteral nutrition is better than parenteral nutrition. Enteral nutrition has fewer risks of major complications, and it offers unique benefits over parenteral nutrition, such as a reduced risk of organ and muscle atrophy. However, the best method for each patient will depend on their specific needs and health condition.

Who Should Have Enteral Feeding? 

Patients who have functioning digestive organs but are unable to eat or swallow food normally are the best candidates for enteral feeding. This may include patients who have suffered a stroke, cancer patients, and patients with various neurological disorders.

Who Shouldn’t Have Enteral Feeding? 

Patients should not have enteral feeding and should be given an alternative feeding method, like parenteral feeding, if they have serious problems with their digestive system, such as organ failure, intestinal obstructions or severe trauma to the stomach.

What Is Total Enteral Nutrition? 

Total enteral nutrition is when a patient receives the totality of their body’s nutrition via enteral feeding. It’s similar to total parenteral nutrition, or TPN, which is when a patient gets all of their nutrients via parenteral feeding.

What Is Exclusive Enteral Nutrition? 

Exclusive enteral nutrition is a form of enteral feeding that is usually used as a primary treatment method for patients with inflammatory bowel disease or Crohn’s disease. It involves the use of a nasogastric tube and provides a constant flow of nutritional formula to the patient’s body to ease symptoms like stomach pain and provide necessary nutrients.

What Is Early Enteral Nutrition?

Early enteral nutrition is when enteral nutrition is provided to a patient within the first 36-48 hours of them being admitted to a hospital, or within 36-48 hours after surgery. This method is often recommended to help manage the care of patients in intensive care units.