Overview
When Enteral Nutrition Fits
Enteral nutrition (EN) delivers formula into the gastrointestinal (GI) tract through a feeding tube when oral intake is unsafe or insufficient.
Enteral nutrition (EN) delivers formula into the gastrointestinal (GI) tract through a feeding tube when oral intake is unsafe or insufficient. The fundamental requirement is not simply an appetite problem; the bowel must be functional and reachable. A working gut allows nutrients to support the intestinal mucosa, gut-associated lymphoid tissue, and normal splanchnic circulation. Prolonged bowel disuse weakens these protective functions. EN may be appropriate for a patient with severe dysphagia after a stroke, impaired consciousness, prolonged critical illness, or head and neck surgery when oral intake cannot meet requirements. It is not appropriate when the intestine is obstructed, severely ischemic, or otherwise unable to receive and move nutrients. In those situations, the interprofessional team evaluates another route, including parenteral nutrition when indicated. Access is chosen according to anticipated duration, aspiration risk, gastric function, and the patient's overall condition: - A nasogastric or orogastric tube is commonly used for short-term access. - A gastrostomy provides longer-term access into the stomach. - A jejunostomy or other post-pyloric tube delivers formula beyond the stomach and may be selected for high aspiration risk...
