An overview of enteral feeding in the community

Enteral nutrition is the provision of nutritional support directly through the gastrointestinal tract. Patients eligible to receive longer term enteral nutrition, as often seen in the community, would have a functioning and accessible gastrointestinal tract, including those with swallowing disorders, such as motor neurone disease and multiple sclerosis; those with physical obstruction to swallowing, such as oesophageal tumours; those unable to ingest food, such as those with head injury or stroke; and those with anorexia due to an underlying disease, such as chronic lung disease, irritable bowel disease or cancer. Patients with dysphagia, anorexia, malabsorption or excessive catabolism may also need long-term enteral feeding (Pearce and Duncan, 2002).

An enteral feeding tube could be placed via a jejunostomy (percutaneous endoscopic jejunostomy (PEJ)) or a gastrostomy, (percutaneous endoscopic gastrostomy (PEG)), with the latter being more common (National Institute for Health and Care Excellence (NICE), 2017). Good nursing care practice would involve awareness of infection control and cleaning of these areas. The site of entry would need to be wiped clean and kept dry so as to prevent any environment being conducive to bacteria growing and an infection starting. An infection at the site of the wound could gain entry systemically and cause sepsis. The tube should be replaced as often as required in accordance with the provider's instructions.