A safety device for tube feeding in Medical Science

There is no denying the fact that a feeding tube is a medical device used to endow with nourishment to patients who cannot get hold of nutrition by mouth, are incapable to gulp down securely, or need nutritional supplementation. The state of being fed by a feeding tube is called gavages, enteral feeding or tube feeding. Placement may be provisional for the treatment of acute conditions or lifelong in the case of chronic disabilities. Multiplicities of feeding tubes are used in medical practice. They are usually made of polyurethane or silicone. The thickness of a feeding tube is unhurried in French units (each French unit equals 0.33 millimeters). They are classified by site of insertion and projected use.

Indicated conditions for application of tube feeding

There are dozens of conditions that may require tube feeding. The more common conditions that necessitate feeding tubes include prematurity, failure to thrive (or malnutrition), neurologic and neuromuscular disorders, inability to swallow, anatomical and post-surgical malformations of the mouth and esophagus, cancer, Sanfilippo syndrome, and digestive confusion.

Types of f devices for tube feeding tubes

Nasal Tubes:

Nasal tubes are non-surgical and temporary. The choice between nasogastric (NG), nasoduodenal (ND) and nasojejunal (NJ) depends on whether your child can tolerate feeding into the stomach or not.

• NG-tubes enter the body through the nose and run down the esophagus into the stomach.
• ND-tubes are similar to NG-tubes, but
• NJ-tubes extend even further to the second they go through the stomach and end in the first portion of the small intestine (duodenum).portion of the small intestine (jejunum). Bypassing the stomach can be beneficial for those whose stomachs don’t empty well, who have chronic vomiting, or who inhale or aspirate stomach contents into the lungs.

Gastric Tubes (or G-tubes):

The most common type of feeding tube is the gastrostomy (G) tube. G-tubes are surgically placed through the abdominal wall into the stomach.

There are a number of types of G-tubes. Any kind of G-tube can be placed initially. Often it is the surgeon or the gastroenterologist who determines the first type of G-tube placed. These are some of the most common types of G-tubes you may encounter.

• PEG and Long Tubes: These are one-piece tubes held in place either by a retention balloon or by a bumper. They are often used as the initial G-tube for the first 8-12 weeks post-surgery.
• Low Profile Tubes or Buttons:  These tubes do not have a long tube permanently attached outside the stomach.  Instead, they have a tube called an extension set that is attached for feeding or medication administration and then disconnected when not in use. When an extension set is not attached to the button, it lies fairly flat against the body. There are two types:
• Balloon buttons:  These are held in place by a water filled balloon. These are the most common G-tubes used in children. They can be changed at home.
• Non balloon buttons: Non-balloon buttons are harder to pull out than balloon buttons.  Non-balloon buttons cannot be replaced at home. They are placed in the doctor’s office or at the hospital, sometimes with sedation or a topical pain reliever.
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When you first enter the world of tube feeding, it feels like there is a whole new language to learn. Knowing more about the different types of tubes and understanding the lingo really helps you better navigate the most appropriate options for your child.

Terms to know:

Flush: Administering water into the feeding tube, usually with a syringe, to clear food, formula or medication, and to keep it from clogging. The amount of the flush is dependent on the length of the tube, but is usually between 10–20mL (about half an ounce) of water.

Bolus Feed: A tube feed that is given like a meal. Typically, a larger amount is given in a short period of time, usually less than 30 minutes. There is often a break, lasting hours between feeds. Bolus feeds can be administered by syringe, gravity bags or a feeding pump. They can be pushed in by syringe or the pump– or allowed to flow in at a comfortable rate by gravity.

Continuous Feed: A tube feed that is slowly dripped in using a feeding pump. It runs over longer periods of time, either overnight or for many hours per day.

Vent/Venting: Letting the air out of the stomach with a feeding tube, usually through an open 60mL syringe.

Feeding Tolerance and Intolerance: How a child reacts to tube feeds. If a child seems happy or content during and after feeding, he is tolerating feeds well. If there is discomfort, coughing, vomiting or retching during or after feedings, then there is feeding intolerance.

Motility/Dysmotility: Motility is how food and liquids move through the GI tract. If there is a motility issue, referred to as dysmotility, then food isn’t moving through as it should. There can be dysmotility at any point in the GI tract, from the esophagus all the way to the stomach, intestines and bowels.

Stoma: The stoma is the tube site itself (for G-, GJ- and J-tubes). It is the opening that connects the feeding tube on the outside of the body to the stomach or intestine on the inside.

PEG: PEG specifically describes a long G-tube placed by endoscopy, and stands for percutaneous endoscopic gastrostomy. Sometimes the term PEG is used to describe all G-tubes.

Types of feeding tubes:

Nasal Tubes:

Nasal tubes are non-surgical and temporary. The choice between nasogastric (NG), nasoduodenal (ND) and nasojejunal (NJ) depends on whether your child can tolerate feeding into the stomach or not.

Ø  NG-tubes enter the body through the nose and run down the esophagus into the stomach.

Ø  ND-tubes are similar to NG-tubes, but they go through the stomach and end in the first portion of the small intestine (duodenum).

Ø  NJ-tubes extend even further to the second portion of the small intestine (jejunum). Bypassing the stomach can be beneficial for those whose stomachs don’t empty well, who have chronic vomiting, or who inhale or aspirate stomach contents into the lungs.

Gastric Tubes (or G-tubes):

The most common type of feeding tube is the gastrostomy (G) tube. G-tubes are surgically placed through the abdominal wall into the stomach. There are a number of types of G-tubes. Any kind of G-tube can be placed initially. Often it is the surgeon or the gastroenterologist who determines the first type of G-tube placed. These are some of the most common types of G-tubes you may encounter.

• PEG and Long Tubes: These are one-piece tubes held in place either by a retention balloon or by a bumper. They are often used as the initial G-tube for the first 8-12 weeks post-surgery.
• Low Profile Tubes or Buttons: These tubes do not have a long tube permanently attached outside the stomach.  Instead, they have a tube called an extension set that is attached for feeding or medication administration and then disconnected when not in use. When an extension set is not attached to the button, it lies fairly flat against the body. There are two types:
• Balloon buttons:  These are held in place by a water filled balloon. These are the most common G-tubes used in children. They can be changed at home.
• Non-balloon buttons: Non-balloon buttons are harder to pull out than balloon buttons.  Non-balloon buttons cannot be replaced at home. They are placed in the doctor’s office or at the hospital, sometimes with sedation or a topical pain reliever.

GJ-tubes:

When you need to bypass the stomach for feeding, there is the Gastro-jejunal (GJ) tube. GJ-tubes are placed in the stomach just like G-tubes, but inside the stomach there is also a thin, long tube threaded into the jejunal (J) portion of the small intestine. The vast majority of children who get GJ feeding tubes begin with G-tubes; it is rare for a GJ-tube to be placed initially. Most GJ-tubes have separate ports to access both the stomach (G port) and the small intestine (J port), though some tubes, often called Trans-jejunal (TJ) tubes, only allow access to the small intestine. GJ-tubes are available both as buttons or long tubes.

Jejunal (J) Tubes

AA Jejunostomy feeding tube (J-tube) is a tube surgically or endoscopically inserted through the abdomen and into the jejunum (the second part of the small intestine).Alternatively a jejunostomy commonly refers to a surgical fistula created connecting the jejunum or the abdominal wall. There are several techniques for placement, including a direct surgical or endoscopic technique, or a more complicated Roux-en-Y procedure. The J-tube may use a long, catheter-like tube or a button. Depending on the placement type, the tube may be changed at home, or may need to be changed at a hospital. A J-tube is helpful for individuals with poor gastric motility, chronic vomiting, or at high risk for aspiration and in those in whom gastrostomy tubes are contraindicated.

In view of the above, it is evident that tube feeding is an important medical device for the good physique of the babies who are confined to strong and stout being free from all sorts of health hazards as a tentative flow. The different tubes are applied in different phases based on the critics of different classes of health conditions. The most common type of feeding tube is the gastrostomy (G) tube. G-tubes are surgically placed through the abdominal wall into the stomach. There are a number of types of G-tubes. Any kind of G-tube can be placed initially. Often it is the surgeon or the gastroenterologist who determines the first type of G-tube placed. These are some of the most common types of G-tubes we may stumble upon for virtual physical strain of the babies in different strategy and optimistic logical stringencies.