cc-feeding-tubes
Nutrition Nursing Team
Feeding Tubes
You may need a feeding tube if you cannot eat or drink enough to maintain your weight. This can be due to either your cancer itself or the side effects following surgery, chemotherapy or radiotherapy. Our bodies need nutrition to function and to heal. A feeding tube can be used to top-up or supplement what you can manage to eat or it can become your main way to obtain nutrition. Feeding tubes can be used for both short and long term periods.
The different types of feeding tube
The type of tube that is chosen for you will depend on; the location of your cancer, how it is affecting you, the staging of your cancer and your overall health. In the team’s assessment they will also take into account your medical history, as this can sometimes determine the kind of the tube that needs to be placed.
There are two main ways of supplying nutrition:
- Enteral Nutrition, using a feeding tube to deliver nutrition into the normal gastric system. This is the most common.
- Parenteral Nutrition, used as a short term measure whilst the ability to receive nutrition orally or via the normal gastric route is not available. It requires specialist monitoring and carries a higher risk of infection as this kind of nutrition is delivered into the vein (intravenously).
A nasogastric tube , the tube is placed into the nose, down the oesophagus and into the stomach. It can often be placed at the bedside, but sometimes the assistance of an x-ray is required. This type of tube can be in place for up to 12 weeks. You will remain in hospital while this type of tube is being used as it requires specific checks each time anything is administered. Discharge home with a nasogastric tube is only considered in exceptional circumstances.
A Nasojejunal tube can be used at home once training has been provided and they can last up to around six months. The tube is placed into the nose, down the oesophagus, into the stomach and then continues through the pylorus into the first part of the small intestine, the jejunum. This type of tube requires an endoscopy or x-ray to place. This is done with or without sedation, but will depend on you and your risk factors.
A gastrostomy tube is a long term feeding option that can be left in place for months or years. It involves a tube being passed through the skin and muscle of the tummy into the stomach. It can be placed under x-ray (RIG) or endoscopically (PEG). This type of tube can be used for several years.
A Jejunostomy is when a small tube is placed directly into the jejunum (small intestine). This type of tube must be placed surgically. Once in place, it can be used for a number of years, if needed.
Frequently asked questions
You might have a lot of questions about having a feeding tube. Here we answer some of the questions our staff are most frequently asked.
If you have any further questions or queries, please do not hesitate to ask one of our team who will be happy to help you.
Is there another option?
We will always complete an individual, holistic assessment to look at what is going to be the best option for you and discuss this with you.
Working alongside the Trust’s dietitians and Speech and Language therapists, the team will always try to support you to eat and drink normally through the mouth.
Who will look after me?
The nutrition nurses are your main point of contact about your feeding tube. They will co-ordinate the tube insertion, see you once it is in place and carry out all of the required monitoring. Once you are no longer coming to the hospital for treatments daily or weekly, you can be referred to a home treatment team for support.
Can I go home with a feeding tube?
Yes. We will discuss options with you and will look at who you have to support you and train you and your family or carers if required.
Will I feel hungry and can I eat/drink?
Eating is such a ‘normal’ thing to do and when you can no longer eat and drink enough to maintain your weight, it can be quite an adjustment. Once receiving your full artificial feed, you will most likely feel full as if you have eaten a meal. However, the process of achieving this and the feeling you experience after will be different to when you are eating solid food.
The reason as to why you need the tube will dictate if you can eat as well. A feeding tube does not always mean that you cannot eat by mouth. Everyone is different and it will also depend on if it is ‘safe’ for you to swallow. Your nutrition nurse will work closely with the Trust’s dietitians and speech and language therapists to advise you.
Will I get shown how to keep it clean?
Yes, if the plan is for you to go home with your tube the team will always train you, your family and carers how to use and maintain the tube.
Can I shower with a feeding tube?
Yes, we will give you specific advice depending on the tube you have fitted. Generally, if you have a nasogastric tube or nasojejunal tube, you need to avoid the dressing getting wet or replace it if it does.
For gastrostomy and Jejunostomy tubes, the team advises careful showering which avoids the site. They do not recommend taking a bath for six weeks or if there is any inflammation, as you must not submerge the tube entry point.
Will I be monitored after my feeding tube is fitted
You will receive routine follow-ups at the start of your treatment and at regular intervals following the tube insertion to perform the required maintenance. You will be supported during these appointments to continue your own care independently.
Once you are competent with using and maintaining your tube, the team can refer you to a home treatment team.
What are the common side effects?
You can initially experience some discomfort at the tube insertion site that will require you to take over the counter pain killers for a short period of time.
Sometimes your bowels can take time to adjust to a different way of receiving nutrition or at a different consistency.
It can also be a psychological adjustment to be ‘eating’ in a different way and to look physically different if you have a feeding tube.
What do I do if I have a problem?
You will be provided with contact details for the nutritional nursing team. You will also be given details of how to get out of hours support.
What happens at the end of my treatment?
Every patient is different and the reasons for having the tube placed will dictate when or if your tube can be removed.
If normal eating, via the mouth, has resumed and the tube has been in place for six weeks or more, then it can be removed. The decision to remove your tube will be made after a treatment follow-up and with input from you, your consultant, speech and language therapists and the dietitians.
Depending on the type of tube you have, removal is usually very simple and mostly done without the need for sedation or an overnight stay.