Enteral Nutrition: Symptoms, Causes, Treatment

It differs from intravenous nutrition, which bypasses the gut. A tube may pass through the nose or abdominal wall into the stomach or intestine, depending on the condition, expected duration and agreed goals.

Related reading: Malnutrition and nutritional support.

Monitor comfort, tolerance, weight, hydration and the tube site. Vomiting, diarrhea, distension or coughing during feeding should be reported. Diarrhea does not automatically mean the formula is the only cause.

It may be considered for swallowing impairment, neurological disease, head-and-neck cancer or inadequate oral intake when the gut can be used. Decisions balance benefits, burdens and the person’s wishes, not weight alone.

Impaired swallowing or consciousness, inadequate training, poor tube care and severe undernutrition increase some risks. Regular review determines whether feeding remains necessary, can be adjusted or can give way to safe oral intake.

The team assesses swallowing, nutritional status, gut function and refeeding risk. Confirm tube position according to tube type and protocol before use. Injecting air and listening over the abdomen does not establish safe nasogastric placement.

The team prescribes formula, volume, rate, water and medication administration and trains the patient or carer. Put no water, feed or medicine through a possibly displaced tube. Do not crush tablets or mix medicines with feed without pharmacist advice.

Risks include aspiration, blockage, displacement, site infection and fluid or electrolyte disturbance. Refeeding syndrome can occur when nutrition restarts after severe depletion and requires clinical prevention and monitoring.

Follow the hygiene, position-check, flushing and upright-positioning plan. Care for the mouth and skin and store formula and equipment correctly. Do not increase rates, use homemade mixtures or improvise blockage-clearing methods without team guidance.