saudigastro.com/patients/enteral-tube-feeding
Results
You can usually start getting nutrition within hours of a nose tube being checked, or within a day of a PEG. Benefits such as steadier weight, better strength and wound healing are seen over weeks, and your dietitian will track your weight, blood tests and tolerance and adjust the feed. How long you need the tube depends on your condition; some people need it for days or weeks, others for months or longer.
This article is educational and does not replace your doctor's advice. Seek urgent care for any red-flag symptoms.
What is it?
“Enteral” means “using the gut”. In tube feeding, a ready-made liquid formula that contains protein, fat, carbohydrate, vitamins and minerals is delivered through a tube straight into the stomach or small bowel. A short-term tube is passed through the nose (a nasogastric tube if it ends in the stomach, or a nasojejunal tube if it ends in the small bowel). For longer use, a tube may be placed through the skin into the stomach (a gastrostomy, for example PEG, percutaneous endoscopic gastrostomy, placed with an endoscope) or into the small bowel (a jejunostomy). Feeds can be given in set meals (bolus), slowly over hours by a pump, or continuously, depending on your needs and tolerance. Special feeds exist for different conditions.
Why is it done?
It is used when someone cannot eat or drink enough by mouth to stay nourished, or cannot do so safely, but the gut can still absorb food. This protects weight, strength, healing and immunity. Reasons include difficulty swallowing after a stroke, a throat or food pipe cancer or narrowing, severe malnutrition, prolonged illness or critical illness, some neurological conditions, and a short period of feeding to rest the bowel or to treat Crohn’s disease (especially in children). It is preferred over drip feeding into a vein (parenteral nutrition) when the gut works, because it is safer, keeps the gut healthy and costs less.
Who needs it?
- People who cannot swallow safely, for example after a stroke, or because of throat, mouth or food pipe disease
- People who are malnourished or losing weight and cannot meet their needs by eating and nutrition drinks
- People in hospital or intensive care who cannot eat for a time
- Children and some adults with Crohn’s disease, when a liquid-only diet is used as treatment
- People with long-term conditions that make eating difficult, such as some neurological diseases
Before the procedure
- A dietitian (a nutrition specialist) and your doctor decide what type of tube and which feed suit you, how much you need, and for how long, based on your condition and swallowing assessment.
- For a nose tube, the team explains the steps; no sedation is usually needed. For a PEG or other surgical tube, you will need to fast for several hours, may have sedation, and may need blood tests. Your team gives exact fasting times.
- Tell the team about all your medicines, especially blood thinners (warfarin, apixaban, rivaroxaban, clopidogrel, aspirin) and diabetes medicines. Never stop them yourself. Some medicines come in forms that can be given through a tube, and some must not be crushed, so ask the pharmacist.
- Tell the team about allergies, previous stomach or bowel surgery, bleeding problems and any history of reflux or aspiration (food going into the airway).
- If you or your family will manage feeding at home, you will be taught how to handle the tube, feed, pump, flushing, hygiene and cleaning. Ask for written instructions and a contact number. If you are fasting for Ramadan, speak to the team, as tube feeding for medical reasons is planned individually.
During the procedure
Nose tube: a soft, thin tube is passed through a nostril and down the throat as you swallow sips of water. It can cause gagging, watering eyes or discomfort for a moment. Its position is checked (by testing stomach fluid or by an X-ray) before any feed is started, and it is taped to the cheek. PEG: under sedation and local anaesthetic, a doctor passes an endoscope into the stomach, and a small cut is made in the belly skin to place the tube into the stomach; this takes about 20 to 30 minutes. Feeding: feed is delivered with a syringe, gravity set or pump, usually sitting upright or with the head raised (to lower the risk of reflux), and the tube is flushed with water before and after. Feeds start slowly and are increased as tolerated.
After the procedure
After a PEG, you are watched for several hours and feeding usually starts the same or next day; the site can be sore for a few days and needs daily cleaning as taught. At home, keep the head of the bed raised or stay sitting upright during and for a while after feeds, flush the tube as instructed, clean the skin around it and check the tube’s position marking. Mouth care is still important even when you are not eating by mouth. Keep contact with the dietitian and nurse for regular reviews of weight, feed type and the tube. Many people continue to eat or drink small amounts if it is safe; your swallowing therapist will advise. Tubes can be changed or removed when no longer needed.
Risks
- Nose tube: nose and throat irritation, nosebleed, the tube blocking, moving or being pulled out; wrong placement in the airway (rare but serious, which is why position is always checked before feeding)
- Feeding problems: nausea, vomiting, bloating, cramps, diarrhoea or constipation; often improved by changing the speed or type of feed
- Aspiration: feed or stomach contents entering the lungs, which can cause pneumonia. Sitting upright during feeds lowers the risk.
- PEG or surgical tube: pain, infection or leakage at the skin site, tube blockage or falling out, bleeding, or rarely a tear or injury to organs, or sedation reactions
- Blood sugar and salt or mineral changes, especially when feeding is restarted after a long period of poor intake (refeeding syndrome), so your team monitors you closely at the start
- Emotional and social effects, such as feeling self-conscious, missing the pleasure of eating or sharing meals; support from the team and family helps.
- Contact your team promptly for fever, redness, swelling, pus or leaking around the tube site, a blocked or displaced tube, persistent vomiting, severe belly pain or swelling, or diarrhoea that does not settle. Seek emergency help for breathing difficulty, choking or coughing during feeds, or if a displaced tube may have gone into the airway.
When you get results
Alternatives if you decline
Options depend on why feeding support is needed. They include food fortification and nutrition drinks by mouth, swallowing therapy and texture-modified diets, and, when the gut cannot be used, feeding directly into a vein (parenteral nutrition). Some people may choose not to have tube feeding, for example near the end of life or in advanced illness, and that is a valid decision to discuss openly with your doctors and family. Declining nutrition support when it is needed can lead to weight loss, weakness and slower recovery.
Questions to ask your doctor
Save this list or print it before your appointment — doctors appreciate prepared patients.
- Which type of tube is best for me, and for how long will I need it?
- Which feed and how much per day, and how will it be adjusted?
- Can I still eat or drink by mouth, and who will check my swallowing?
- How do I give medicines, flush the tube and keep the site clean at home?
- Who do I call if the tube blocks, comes out or I feel unwell?
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Status: Approved for publication by SGA; individual clinician review is ongoing · Published 24/04/2026
For general education only; it does not replace your doctor’s advice. Individual clinician review of this guide is ongoing. SGA clinician? Review this guide