Knowledge is Power

I know this post may not be immediately relevant to most people, but I have witnessed a lot of confusion surrounding this topic in the hospital. People fear tube feeding. This is an unfortunate misunderstanding and I see families making decisions based on the stigma surrounding tube feeding. I want to provide some insight into a seemingly scary situation so that you may be better equipped to make a difficult decision in the future.

So, there are certain conditions under which a person cannot eat. If your doctor thinks that this situation may last more than a few days, they may begin to consider nutrition support. (YES! You can go several days without eating and you will be fine. Promise! I do not recommend this just for kicks. But if you are in the hospital and haven’t eaten in three days, it’s not the end of the world.) First, let’s talk about some of the medical conditions that may require nutrition support. Reasons may include: having a condition that requires a large amount of calories and  not being able to meet those needs by eating food, a blockage or obstruction within the intestine, inability to eat due to being on a ventilator, malabsorption issues, pancreatitis, etc.

Nutrition support comes in two forms: enteral nutrition (tube feeding) or parenteral nutrition (delivered through an IV). People believe these two routes of nutrition are interchangeable, but they are not. The basic rule of thumb is, “if the gut works, use it.” Meaning, if the gastrointestinal tract is still functioning, it should be used. There really are only a handful of conditions that actually require parenteral, or IV, nutrition. These can include an obstruction, chronic pancreatitis or being hemodynamically unstable. Nutrition delivered straight the the vein is much more serious. It is not a long-term option and is very hard on the liver, it requires very close monitoring of labs, and not using the gut can cause it to atrophy.

enteral_parenteral_fig1

I realize that not being able to eat and having to rely on nutrition support is scary. I don’t wish anyone to be in that position.  But I have seen so many families insist that their loved one not be tube fed but are fine with the IV, even though tube feeding would be much more beneficial. Tube feeding may appear scarier, because you either have a tube coming out of your nose or your stomach. And it’s just so easy to put something else through your IV. I get it. But if you are medically able, tube feeding is way more beneficial. Have an honest conversation with your doctor and be open to all options. This is merely a broad overview of a very complicated topic. Each person and illness is different.

If you are curious about tube feeding, there are actually tons of YouTube videos of people sharing their personal experiences. Many of them are children. Check it out.

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