Tube feedings can be confusing. No disease state improves significantly with starvation, but delivering nutrition to those who are unable to eat can be a challenge. Tube feeding is often the best way to manage the challenge. Unless you are medically trained, it is likely you know the difference between a Peg Tube or a G Tube nor how and when should they be used. Here are some basics:
- Peg Tube – Percutaneous Endoscopic Gastronomy tube. This is placed into the stomach using an endoscope. GI docs can do this as well as surgeons. It can be done in the Intensive Care Unit, Endoscopy Suite or Operating Room.
- G tube- Gastronomy tube. Also a tube in the stomach but is placed by making an incision in the abdomen and surgically placing the tube in the stomach. Most frequently done during another operation requiring an incision. Also necessary if the patient pulls out the PEG soon after insertion.
- J tube – Jejunostomy tube. J-tubes are tubes that are directly placed into the small intestine. These tubes are not very common. They require surgical placement. Depending on the type of surgery and tube, the J-tube may be able to be replaced at home. Feedings must be given slowly, over 18-24 hours.
A doctor will most commonly use a Peg Tube or a G Tube for patients needing feedings for over three months. It is extremely helpful in patients with throat cancer or many other physical or neurological conditions. Current research shows that patients with advanced dementia who are unable to feed themselves should have another person feed them in preference to the medical intervention of having a feeding tube. In such patients, feeding tubes do not increase life expectancy or protect the patient from aspiration pneumonia. Feeding tubes can also increase the risk of pressure ulcers, require pharmacological or physical restraints, and lead to patient distress. There is evidence which shows that patients who get feeding assistance rather than tubes have better outcomes. In the final stages of dementia, assisted feeding may still be preferred over a feeding tube to bring benefits of palliative care and human interaction even when nutritional goals are not being met