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What Is Enteral and Parenteral Nutrition?

Hanging IV bag with solution.
A catheter can be used to provide enteral nutrition.
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  • Written By: Caitlin Kenney
  • Edited By: Bronwyn Harris
  • Last Modified Date: 11 March 2014
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Enteral and parenteral nutrition are two means of delivering nutrition to patients who cannot digest food normally. Enteral feeding delivers liquid nutrition through a catheter inserted directly into the gastrointestinal (GI) tract. Parenteral nutrition provides nutrition intravenously, or directly into the bloodstream. Both types of nutrition are provided in liquid form and can include medicine as well as food. Because it presents less risk, enteral feeding is preferred to intravenous feeding when the option is available.

These types of nutrition are used on patients who have damaged or non-functioning GI tracts. The GI tract is the group of organs through which food travels to be digested and excreted. These organs include the mouth, where food is taken into the body, the pharynx, the esophagus, the stomach, and the intestines, or bowels, which are responsible for the final break-down, absorption, and excretion of food.

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Different enteral feeding tubes may be used for different patient’s needs. A nasal tube is run through the patient’s nasal passageway, through the esophagus, into the stomach. This bypasses the mouth and throat, but still uses the stomach. Nasal tubes cannot be used, however, on patients with obstructions in the esophagus or injuries to the mid-face. In these cases, a gastric feeding tube may be surgically placed directly into the stomach, avoiding the nose, mouth, and throat. These procedures are usually performed on patients who have mouth or throat cancer, trauma to the mouth or throat, neurological problems that prevent the patient from swallowing, or patients with a severe eating disorder, such as anorexia nervosa.

When a patient’s stomach is unfit for normal digestion or a catheter, doctors may recommend a jejunostomy tube (J-tube), instead. The J-tube is a feeding tube that is surgically placed in the jejunum, or the middle segment of the small intestine. In the digestive tract, the small intestine is positioned after the stomach and is used to break down and absorb food.

Sometimes, enteral feeding is not an option due to post-surgery paralysis of the GI tract, chronic diarrhea or vomiting, or for starving patients who need surgery. These patients may require total parenteral nutrition (TPN), which delivers nutrition solely through intravenous feeding. Medical professionals typically insert catheters into either the jugular vein; the subclavian vein, below the clavicle; or one of the arm’s large blood vessels. TPN is also recommended for babies with underdeveloped digestive systems, patients with birth defects along the GI tract, patients suffering bowel obstructions, and patients with Crohn’s disease, an inflammation of the bowels.

Many times, a patient can return to normal eating after he regains the strength, but some patients continue to need tube feeding for a long period of time. Both enteral and parenteral nutrition patients can administer food independently from home in certain chronic cases. These patients often choose to do feedings at night, in order to have their lifestyles be as normal as possible during the day. Feeding operations and care will vary from case to case.

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Discuss this Article

anon928919
Post 6

@anon213472: I am a dietetics student on her way to become a registered dietitian. To answer your question as best as I could, I would say that a feeding tube will prolong his life, but only enough for him to not die of inadequate nutrition (which can cause worse heart problems, more weight loss, etc). It will not give him an abundance of energy. The amounts titrated will only be enough to sustain life. In addition, surgery is only needed if his mouth, nose, and throat are inaccessible. If they aren't, he will he a nasal tube that's placed in 15 minutes without surgery.

anon337088
Post 5

In answer to your question, it will just prolong your husband's current life. If he is not eating currently, it will provide additional calories and energy into him. However if he is eating, they could and should offer to provide nutritional supplements for increased calorie intake. You should know this is a surgery that has discomfort and risks associated with it.

anon213472
Post 4

I would like to know if this is a last ditch means at sustaining life? My husband is an ESRD, COPD and heart patient! He has lost an enormous amount weight. His doctors have said he has reached zero quality life, he has no interests and exists from one day to the next. He is a permanent resident in a nursing facility. His condition has come to the point that I can no longer care for him at home.

His dialysis clinic wants to try this procedure in order to give him more energy and maybe put some weight on. I want someone who will answer my questions honestly.

Is this something that will give him quality life or just prolong the life he currently has? Someone please answer my questions honestly! I am tired of watching him suffer.

donna61
Post 3

@healthnwell--This can be a hard time for the patient and the family, we had someone in our family that needed parenteral nutrition for quite some time. I hope your friend feels better soon. We found great information and support by contacting the Oley Foundation and the patient information section of the American Society for Enteral and Parenteral Nutrition (A.S.P.E.N.). They both have extensive websites. Good Luck!

healthnwell
Post 2

A friend of our family has had to have enteral feeding support for quite a while now; does anyone know of a website where they can look for educational and emotional support? Thanks for any info!

anon110888
Post 1

Great information and easy to understand. Thanks.

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