Benefits and Complications of Enteral Feeding
Benefits of enteral feeding include the provision of adequate nutrition and the avoidance or correction of malnutrition. If the gut works, enteral feeding is always preferable because it is associated with less infection risk and cheaper cost. Keeping the gut working can also be physiological and can prevent GI dystrophy as well as bacterial translocation.
Enteral feeding has risks and complications. For example, placement of the temporary NG/OG tubes may be incorrect, and permanent feeding tubes can become blocked or dislodged. Any patient, especially one who is uncooperative or confused, can also pull out the feeding tube, causing disruptions in the feedings and possibly exacerbating preexisting malnutrition. In addition, the head of the bed must be kept at 30 degrees or greater to prevent aspiration, the wrongful delivery of tube feeding formula or even saliva down to the lungs, and aspiration pneumonia. Tubes can also become clogged despite regular water flushes and good care. To de-clog feeding tubes, warm water, enzymatic agents, and mechanical devices may be used. Carbonated beverages, juices, and meat tenderizer are not acceptable methods of unclogging feeding tubes and in fact, may worsen the clog.
Once enteral nutrition is initiated, other complications may arise. The most reported side effect in patients receiving enteral feeding is a complaint of diarrhea or loose stool, thought to be caused by intolerance to the tube feeding formula. However, bowel movements may be caused by the simple act of nutrition initiation and digestion. Medications (such as those in sorbitol base, antibiotics, bowel regimen) and infection are also possible causes of diarrhea that should be considered as well.
Constipation is another common side effect of enteral nutrition. Causes include dehydration, inadequate or excessive fiber in the tube feeding regimen, and immobility (such as those on sedation in critical care or those that are bed-bound). Adequate fiber and hydration should be provided, and a bowel regimen should be initiated as needed.