Methods of alternative feeding

When patients are unable to get enough food orally and have functional gastrointestinal tract and the digestive system, some methods of alternative feeding are applied.


One alternative method is long-term intravenous feeding. This method is not desirable in terms of both cost efficiency and comfort. However, it is used for short periods and until the patient is suitable for oral feeding. It is preferred for patients who cannot be fed through orally or via feeding tube.

Other alternative methods is the advancement of the nasally inserted feeding tubes into the stomach and small intestine (through nasogastric or nasojeunal tracts). The presence of the nasal catheters for a long time is uncomfortable for patient and may cause ulcers related to pressure in the nasal, throat, esophagus and stomach mucosa. They carry risks for the formation of some infections. It is an important limiting feature for them is to come out easily. They also need to be replaced when long-term use is required.

In Anadolu Medical Center we recommend PEG, PEJ and PEG-J as effective and comfortable methods of alternative feeding. Percutaneous endoscopic feeding tubes may be inserted into the stomach (PEG) and into the small intestine (PEJ), or may be placed in the form of a feeding catheter into the small intestine through the tube previously inserted into the stomach (PEG-J). With these methods, a thin tube can be inserted into the stomach or small intestine through the endoscope to ensure that foods and drugs reach directly to the digestive tract in patients who cannot be fed orally for various reasons.

The procedure takes 30 to 45 minutes. A complete upper gastrointestinal endoscopic examination is performed prior to this (esophagogastroduodenoscopy). Then the tube is placed through the abdominal wall. This varies depending on the course of the operation. The operation is usually safe. The incidence of complications during the procedure is not very different from that in standard endoscopic procedures. If a biopsy is performed or during the operation, a pathology report is issued by the pathology department.

Although the success rate of the procedure is 95-100%, the procedure may not be completed due to beyond control reasons (such as stenosis in the stomach and intestines, former surgeries, previous radiotherapy, etc.). Alternative feeding methods will be used in case of incomplete operation or when the operation is not takes place.

 


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