By: by Lauren Bryan
Reviewed by a registered dietitian.
Understanding Feeding Tubes as a Method of Nutrition Support: A Guide for Patients and Caregivers
Feeding tubes are medical devices used to deliver nutrition, hydration, and medication to individuals who are unable to meet their nutritional needs orally due to illness, injury, or neurological impairment. They provide nutrients directly into the gastrointestinal (GI) tract or via IV catheters into the bloodstream, when eating or swallowing is unsafe or insufficient. Feeding tubes and IV’s play a vital role in preventing malnutrition, supporting recovery, and possibly improving quality of life for individuals with compromised oral intake.¹
What Is a Feeding Tube?
A feeding tube is a small, soft tube placed in the body to help deliver food, fluids, and medicine when a person can’t eat or drink enough on their own. It’s a safe and common way to make sure the body gets the nutrition it needs.
Two Main Types of Feeding Tubes
Feeding support is typically categorized into two primary types: enteral nutrition and parenteral nutrition, depending on whether the digestive system can be used.
Enteral Nutrition (Tube Feeding into the Stomach or Intestine). Enteral nutrition is when a feeding tube is placed into the digestive system, either through the nose or directly into the stomach or intestine. This is the most common kind of feeding support.2 This method is preferred whenever the gut is functional, as it helps maintain digestive health and supports the body’s natural metabolism. Common types include:
- Nasogastric (NG) tube – inserted through the nose and into the stomach; used for short-term support
- Gastrostomy (G-tube) – inserted through the abdominal wall into the stomach for long-term feeding
- Jejunostomy (J-tube) – placed into the small intestine, often used when stomach feeding is not tolerated
Enteral nutrition is indicated in conditions such as dysphagia (difficulty swallowing), neurological diseases (e.g., stroke, ALS, Parkinson’s disease), head and neck cancers, and when oral intake is inadequate.3 The guiding principle is: “If the gut works, use it.”
Parenteral Nutrition (IV Nutrition). Parenteral nutrition bypasses the digestive system entirely, delivering nutrients intravenously either through a central vein or peripheral vein, depending on the volume and type of nutrition required.⁴ Parenteral nutrition is used when the stomach or intestines cannot absorb food or fluids. This can occur after certain surgeries, especially involving the gut, or in severe conditions like Crohn’s disease, bowel obstructions, or short bowel syndrome.4
Parenteral nutrition is helpful as it delivers all nutrients (protein, carbohydrates, fat, vitamins, and minerals) straight into the bloodstream, bypassing the gut. Parenteral nutrition is typically used for shorter periods or when necessary because it carries a higher risk of infection and requires careful monitoring by a healthcare team.4
What Is in the Tube? Understanding Formulas
Feeding tube formulas are liquid meals made with important nutrients like protein for muscle health, carbohydrates for energy, fats for long-lasting fuel, and vitamins and minerals to keep the body balanced. Some formulas are made for people with specific health needs, such as diabetes or food allergies. A doctor and/or dietitian will help choose the best formula for each person. Formulas vary in energy and nutrient density as nutrition needs depend on an individual’s needs and medical conditions.5
There are also different feeding methods:
- Bolus feeding mimics regular mealtimes and delivers larger volumes several times a day
- Continuous feeding delivers smaller amounts over time, often used for J-tubes or patients who cannot tolerate large volumes
The formula, schedule, and delivery method are all personalized to meet the individual’s nutritional and medical needs.⁵
Nutritional Support and Neurological Diseases
Feeding tubes are often used in people with neurological diseases like:
- Amyotrophic lateral sclerosis (ALS or Lou Gehrig’s Disease)
- Parkinson’s disease
- Stroke
- Multiple sclerosis
These conditions can affect swallowing and movement, making it harder to eat enough to meet the body’s energy needs. A feeding tube might improve quality of life, reduce the risk of choking, and prevent malnutrition. Decisions regarding tube placement are made carefully, weighing risks and benefits, and guided by a multidisciplinary care team.6
Prioritizing Nutrition When Eating Orally Becomes Difficult
While the idea of using a feeding tube may feel intimidating at first, it is a powerful tool for promoting health, comfort, and healing. Whether temporary or long-term, tube feeding ensures the body receives essential nutrients when oral intake is not possible. Oral intake after feeding tube placement may be permitted following evaluation by a speech-language pathologist (SLP).7 If deemed safe, patients can continue to enjoy select foods in small amounts, often referred to as “pleasure feeds.” These typically include texture-appropriate, easy-to-swallow options such as small bites of ice cream, smoothies, or other preferred soft foods. Pleasure feeds can offer both comfort and enjoyment alongside nutritional support.
If you’re a caregiver, know that you are not alone, there are resources, professionals, and support systems available to guide you. For patients, a feeding tube is not a setback, it’s a step toward promoting strength, dignity, and quality of life.
References:
UCLA Health. Malnutrition treatment: feeding tube vs. IV nutrition. UCLA Health. Published October 6, 2023. https://medschool.ucla.edu/news-article/malnutrition-treatment-feeding-tube-vs-iv-nutrition
Doley J. Enteral Nutrition Overview. Nutrients. 2022;14(11):2180. Published 2022 May 24. doi:10.3390/nu14112180
Cleveland Clinic. Tube feeding (enteral nutrition). Cleveland Clinic. Updated April 4, 2024. https://my.clevelandclinic.org/health/treatments/21098-tube-feeding–enteral-nutrition
Cleveland Clinic. Parenteral nutrition. Cleveland Clinic. Updated December 12, 2023. https://my.clevelandclinic.org/health/treatments/22802-parenteral-nutrition
Oral Cancer Foundation. Commercial formulas for the feeding tube. Oral Cancer Foundation. https://oralcancerfoundation.org/nutrition/commercial-formulas-feeding-tube/
Stavroulakis T, McDermott CJ. Enteral feeding in neurological disorders. Pract Neurol. 2016;16(5):352-361. doi:10.1136/practneurol-2016-001408
ALS Association. FYI: Information about feeding tubes. ALS Association. https://www.als.org/navigating-als/resources/fyi-information-about-feeding-tubes