Several different types of feeding tubes are used to supply nutrition to patients unable to eat. Temporary feeding issues may require a naso-gastric (NG) tube, which is inserted through the mouth or nose down the throat and into the stomach. Percutaneous endoscopic gastrostomy (PEG) and jejunal tubes are placed into the stomach or bowel in a minor surgical procedure. These tubes can remain in place longer than NG tubes and aren't as annoying to patients. As with any medical procedure, complications can arise during feeding tube placement of any type.
Insertion Trauma
Inserting an NG tube too roughly or forcing the tube if an obstruction is encountered can cause traumatic injury to the mouth, nose, throat, esophagus or stomach, including perforation and bleeding, the Encyclopedia of Nursing and Allied Health states.
Improper Placement
The trachea, which goes to the lungs, and the esophagus, which goes to the stomach, are two tubes that lie next to each other. If an NG tube is inserted into the trachea instead of the esophagus, the feeding will go into the lung instead of the stomach if tube placement isn't checked before a feeding is started. Serious pneumonia can result from any of the feeding going into the lung. If a patient is responsive, he will usually cough, choke or be unable to talk if the tube goes into the trachea. Intracranial insertion is a small but documented risk, lead author Shai Gavi, M.D., states in an article published in the April 1, 2008 edition of Annals of Long-Term Care entitled "Management of Feeding Tube Complications in the Long-Term Care Resident."
Tube placement can be checked by pushing air into the tube while listening to the stomach with a stethoscope; the air will be heard passing into the stomach. Aspiration of stomach contents, which are clear or yellowish, is another way of checking tube placement, according to Healthline. The safest way is X-ray of the stomach, where the tube can be visualized.
Perforation
Perforation of the stomach or intestines can occur with PEG tube placement, the American Society for Gastrointestinal Endoscopy states. Perforation can also occur with jejunal tube or NG placement.
References
- Society for Gastrointestinal Endoscopy: Percutaneous Endoscopic Gastrostomy
- Encyclopedia of Nursing and Allied Health: Nasogastric Intubation and Feeding
- Healthline: Nasogastric and Feeding Tube Information
- Annals of Long Term Care:"Management of Feeding Tube Complications in the Long-Term Care Resident"; Shai Gavi, M.D. et al; April 1, 2008
