Question

Michael Reyes, a 27-year-old man with an inflammatory intestinal disease, underwent a surgical procedure in which a substantial portion of his small intestine was removed. He had received TPN prior to surgery and continued to receive it afterwards. After 10 days, tube feedings were initiated and delivered in very small feedings.

Why is it important that Michael begin enteral feedings as soon as possible? Assuming that Michael eventually tolerates tube feedings, in what ways can the health care team help him make the transition from parental nutrition to tube feedings? Consider some of the physiological problems that Michael might face when he begins a regular diet.

Answer 1

Enternal feeding is a type of feeding where fluid diet is given to the patient via a nasogastric tube directly into stomach.

The reading for starting enternal feeding as soon as possible in this case of intestinal surgery are

• To prevent weight loss ,because intestine plays a vital role in absorption of nutrients
• Infection and anesthetic dehiscence
• It can greatly reduce the risk of abscess formation in the abdomen
• Enhance wound heskingband function of stomach
• To decrease the length of postoperative hospital stay because oral feeds can be started when fluids are tolerated via NG feed

While there is a transition from parental to enternal the following things can be taught to the patient

• An assistant will be needed to feed as it is tube passed via nose
• The type of diet he is going to get ,its quantity, frequency can make him aware of what he is fed.
• Encourage the patient to come out with any complaints.

The psychological issues which the patient may face while beginning a regular diet

• Usually sips of water are started with the enternal tive at first and checked for any aspiration, tolerance but thus can make the patient discomfortble by trying to swallow with tube
• Difficulty in chewing foods can alter their taste sensation and desire towards food
• A bland diet postoperatively may be easier to eat but may make patient regret that how long will it take to eat a normal or regular diet