Skip to main content
Postgraduate Medical Journal logoLink to Postgraduate Medical Journal
. 2002 Apr;78(918):198–204. doi: 10.1136/pmj.78.918.198

Enteral feeding. Nasogastric, nasojejunal, percutaneous endoscopic gastrostomy, or jejunostomy: its indications and limitations

C Pearce 1, H Duncan 1
PMCID: PMC1742333  PMID: 11930022

Abstract

The following article is intended to provide a review of the current state of enteral feeding; a rapidly changing and developing field. It covers the type of feed, the routes of access, and the problems that can occur with enteral feeding.

Full Text

The Full Text of this article is available as a PDF (110.6 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bury K. D., Jambunathan G. Effects of elemental diets on gastric emptying and gastric secretion in man. Am J Surg. 1974 Jan;127(1):59–64. doi: 10.1016/0002-9610(74)90012-9. [DOI] [PubMed] [Google Scholar]
  2. Cole S. J., Duncan H. D., Silk D. B. Intestinal motility. Curr Opin Clin Nutr Metab Care. 1998 Sep;1(5):415–417. doi: 10.1097/00075197-199809000-00008. [DOI] [PubMed] [Google Scholar]
  3. DiSario J. A., Foutch P. G., Sanowski R. A. Poor results with percutaneous endoscopic jejunostomy. Gastrointest Endosc. 1990 May-Jun;36(3):257–260. doi: 10.1016/s0016-5107(90)71018-8. [DOI] [PubMed] [Google Scholar]
  4. Duncan H. D., Bray M. J., Kapadia S. A., Bowling T. E., Cole S. J., Gabe S. M., Walters E. R., Silk D. B. Prospective randomized comparison of two different sized percutaneous endoscopically placed gastrostomy tubes. Clin Nutr. 1996 Dec;15(6):317–320. doi: 10.1016/s0261-5614(96)80007-0. [DOI] [PubMed] [Google Scholar]
  5. Duncan H. D., Silk D. B. Diagnosis and treatment of malnutrition. J R Coll Physicians Lond. 1997 Sep-Oct;31(5):497–502. [PMC free article] [PubMed] [Google Scholar]
  6. Eldar S., Meguid M. M. Pneumothorax following attempted nasogastric intubation for nutritional support. JPEN J Parenter Enteral Nutr. 1984 Jul-Aug;8(4):450–452. doi: 10.1177/0148607184008004450. [DOI] [PubMed] [Google Scholar]
  7. Fiaccadori E., Borghetti A. Pathophysiology of respiratory muscles in course of undernutrition. Ann Ital Med Int. 1991 Oct-Dec;6(4):402–407. [PubMed] [Google Scholar]
  8. Gaggiotti G., Orlandoni P., Boccoli G., Caporelli S. G., Patrizi I., Masera N. A device to perform percutaneous cervical pharyngostomy (PCP) for enteral nutrition. Clin Nutr. 1989 Oct;8(5):273–275. doi: 10.1016/0261-5614(89)90039-3. [DOI] [PubMed] [Google Scholar]
  9. Gauderer M. W., Ponsky J. L., Izant R. J., Jr Gastrostomy without laparotomy: a percutaneous endoscopic technique. J Pediatr Surg. 1980 Dec;15(6):872–875. doi: 10.1016/s0022-3468(80)80296-x. [DOI] [PubMed] [Google Scholar]
  10. Guenter P. A., Settle R. G., Perlmutter S., Marino P. L., DeSimone G. A., Rolandelli R. H. Tube feeding-related diarrhea in acutely Ill patients. JPEN J Parenter Enteral Nutr. 1991 May-Jun;15(3):277–280. doi: 10.1177/0148607191015003277. [DOI] [PubMed] [Google Scholar]
  11. Gutierrez E. D., Balfe D. M. Fluoroscopically guided nasoenteric feeding tube placement: results of a 1-year study. Radiology. 1991 Mar;178(3):759–762. doi: 10.1148/radiology.178.3.1899727. [DOI] [PubMed] [Google Scholar]
  12. Hicks M. E., Surratt R. S., Picus D., Marx M. V., Lang E. V. Fluoroscopically guided percutaneous gastrostomy and gastroenterostomy: analysis of 158 consecutive cases. AJR Am J Roentgenol. 1990 Apr;154(4):725–728. doi: 10.2214/ajr.154.4.2107665. [DOI] [PubMed] [Google Scholar]
  13. Hill G. L. Jonathan E. Rhoads Lecture. Body composition research: implications for the practice of clinical nutrition. JPEN J Parenter Enteral Nutr. 1992 May-Jun;16(3):197–218. doi: 10.1177/0148607192016003197. [DOI] [PubMed] [Google Scholar]
  14. Hull M. A., Rawlings J., Murray F. E., Field J., McIntyre A. S., Mahida Y. R., Hawkey C. J., Allison S. P. Audit of outcome of long-term enteral nutrition by percutaneous endoscopic gastrostomy. Lancet. 1993 Apr 3;341(8849):869–872. doi: 10.1016/0140-6736(93)93072-9. [DOI] [PubMed] [Google Scholar]
  15. Iyer V. S., Reichel J. Perforation of the esophagus by a fine feeding tube. N Y State J Med. 1984 Feb;84(2):63–64. [PubMed] [Google Scholar]
  16. Jacobs S., Chang R. W., Lee B., Bartlett F. W. Continuous enteral feeding: a major cause of pneumonia among ventilated intensive care unit patients. JPEN J Parenter Enteral Nutr. 1990 Jul-Aug;14(4):353–356. doi: 10.1177/0148607190014004353. [DOI] [PubMed] [Google Scholar]
  17. James R. H. An unusual complication of passing a narrow bore nasogastric tube. Anaesthesia. 1978 Sep;33(8):716–718. doi: 10.1111/j.1365-2044.1978.tb08467.x. [DOI] [PubMed] [Google Scholar]
  18. Jarnagin W. R., Duh Q. Y., Mulvihill S. J., Ridge J. A., Schrock T. R., Way L. W. The efficacy and limitations of percutaneous endoscopic gastrostomy. Arch Surg. 1992 Mar;127(3):261–264. doi: 10.1001/archsurg.1992.01420030023003. [DOI] [PubMed] [Google Scholar]
  19. Kapadia S. A., Raimundo A. H., Silk D. B. The effect of a fibre free and fibre supplemented polymeric enteral diet on normal human bowel function. Clin Nutr. 1993 Oct;12(5):272–276. doi: 10.1016/0261-5614(93)90045-6. [DOI] [PubMed] [Google Scholar]
  20. Keohane P. P., Attrill H., Jones B. J., Silk D. B. Limitations and drawbacks of 'fine bore' nasogastric feeding tubes. Clin Nutr. 1983 Jul;2(2):85–86. doi: 10.1016/0261-5614(83)90038-9. [DOI] [PubMed] [Google Scholar]
  21. Marcuard S. P., Perkins A. M. Clogging of feeding tubes. JPEN J Parenter Enteral Nutr. 1988 Jul-Aug;12(4):403–405. doi: 10.1177/0148607188012004403. [DOI] [PubMed] [Google Scholar]
  22. McWey R. E., Curry N. S., Schabel S. I., Reines H. D. Complications of nasoenteric feeding tubes. Am J Surg. 1988 Feb;155(2):253–257. doi: 10.1016/s0002-9610(88)80708-6. [DOI] [PubMed] [Google Scholar]
  23. McWhirter J. P., Pennington C. R. Incidence and recognition of malnutrition in hospital. BMJ. 1994 Apr 9;308(6934):945–948. doi: 10.1136/bmj.308.6934.945. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. McWhirter J. P., Pennington C. R. Incidence and recognition of malnutrition in hospital. BMJ. 1994 Apr 9;308(6934):945–948. doi: 10.1136/bmj.308.6934.945. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Mellinger J. D., Ponsky J. L. Percutaneous endoscopic gastrostomy: state of the art, 1998. Endoscopy. 1998 Feb;30(2):126–132. doi: 10.1055/s-2007-1001238. [DOI] [PubMed] [Google Scholar]
  26. Moran B. J., Taylor M. B., Johnson C. D. Percutaneous endoscopic gastrostomy. Br J Surg. 1990 Aug;77(8):858–862. doi: 10.1002/bjs.1800770805. [DOI] [PubMed] [Google Scholar]
  27. NAGLER R., SPIRO H. M. PERSISTENT GASTROESOPHAGEAL REFLUX INDUCED DURING PROLONGED GASTRIC INTUBATION. N Engl J Med. 1963 Sep 5;269:495–500. doi: 10.1056/NEJM196309052691003. [DOI] [PubMed] [Google Scholar]
  28. Olivares L., Segovia A., Revuelta R. Tube feeding and lethal aspiration in neurological patients: a review of 720 autopsy cases. Stroke. 1974 Sep-Oct;5(5):654–657. doi: 10.1161/01.str.5.5.654. [DOI] [PubMed] [Google Scholar]
  29. Patil D. H., Grimble G. K., Keohane P., Attrill H., Love M., Silk D. B. Do fibre containing enteral diets have advantages over existing low residue diets? Clin Nutr. 1985 May;4(2):67–71. doi: 10.1016/0261-5614(85)90044-5. [DOI] [PubMed] [Google Scholar]
  30. Payne-James J. J., Rana S. K., Bray M. J., McSwiggan D. A., Silk D. B. Retrograde (ascending) bacterial contamination of enteral diet administration systems. JPEN J Parenter Enteral Nutr. 1992 Jul-Aug;16(4):369–373. doi: 10.1177/0148607192016004369. [DOI] [PubMed] [Google Scholar]
  31. Payne-James J., Silk D. Clinical nutrition support. BMJ. 1990 Jul 7;301(6742):1–2. doi: 10.1136/bmj.301.6742.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Payne-James J., Silk D. Enteral nutrition: background, indications and management. Baillieres Clin Gastroenterol. 1988 Oct;2(4):815–847. doi: 10.1016/0950-3528(88)90037-1. [DOI] [PubMed] [Google Scholar]
  33. Payne-James J., Silk D. Enteral nutrition: background, indications and management. Baillieres Clin Gastroenterol. 1988 Oct;2(4):815–847. doi: 10.1016/0950-3528(88)90037-1. [DOI] [PubMed] [Google Scholar]
  34. Pearce C. B., Collett J., Goggin P. M., Duncan H. D. Enteral nutrition by nasojejunal tube in hyperemesis gravidarum. Clin Nutr. 2001 Oct;20(5):461–464. doi: 10.1054/clnu.2001.0484. [DOI] [PubMed] [Google Scholar]
  35. Pearce C. B., Goggin P. M., Collett J., Smith L., Duncan H. D. The 'cut and push' method of percutaneous endoscopic gastrostomy tube removal. Clin Nutr. 2000 Apr;19(2):133–135. doi: 10.1054/clnu.2000.0100. [DOI] [PubMed] [Google Scholar]
  36. Pennington C. R., Powell-Tuck J., Shaffer J. Review article: artificial nutritional support for improved patient care. Aliment Pharmacol Ther. 1995 Oct;9(5):471–481. doi: 10.1111/j.1365-2036.1995.tb00409.x. [DOI] [PubMed] [Google Scholar]
  37. Pennington C. R., Powell-Tuck J., Shaffer J. Review article: artificial nutritional support for improved patient care. Aliment Pharmacol Ther. 1995 Oct;9(5):471–481. doi: 10.1111/j.1365-2036.1995.tb00409.x. [DOI] [PubMed] [Google Scholar]
  38. Rana S. K., Bray J., Menzies-Gow N., Jameson J., Payne James J. J., Frost P., Silk D. B. Short term benefits of post-operative oral dietary supplements in surgical patients. Clin Nutr. 1992 Dec;11(6):337–344. doi: 10.1016/0261-5614(92)90084-4. [DOI] [PubMed] [Google Scholar]
  39. Rees R. G., Attrill H., Quinn D., Silk D. B. Improved design of nasogastric feeding tubes. Clin Nutr. 1986 Nov;5(4):203–207. doi: 10.1016/0261-5614(86)90026-9. [DOI] [PubMed] [Google Scholar]
  40. Reilly J. J., Jr, Hull S. F., Albert N., Waller A., Bringardener S. Economic impact of malnutrition: a model system for hospitalized patients. JPEN J Parenter Enteral Nutr. 1988 Jul-Aug;12(4):371–376. doi: 10.1177/0148607188012004371. [DOI] [PubMed] [Google Scholar]
  41. Reilly J. J., Jr, Hull S. F., Albert N., Waller A., Bringardener S. Economic impact of malnutrition: a model system for hospitalized patients. JPEN J Parenter Enteral Nutr. 1988 Jul-Aug;12(4):371–376. doi: 10.1177/0148607188012004371. [DOI] [PubMed] [Google Scholar]
  42. Safadi B. Y., Marks J. M., Ponsky J. L. Percutaneous endoscopic gastrostomy: an update. Endoscopy. 1998 Nov;30(9):781–789. doi: 10.1055/s-2007-1001422. [DOI] [PubMed] [Google Scholar]
  43. Schreiner R. L., Eitzen H., Gfell M. A., Kress S., Gresham E. L., French M., Moye L. Environmental contamination of continuous drip feedings. Pediatrics. 1979 Feb;63(2):232–237. [PubMed] [Google Scholar]
  44. Silk D. B., Bray M. J., Keele A. M., Walters E. R., Duncan H. D. Clinical evaluation of a newly designed nasogastric enteral feeding tube. Clin Nutr. 1996 Dec;15(6):285–290. doi: 10.1016/s0261-5614(96)80001-x. [DOI] [PubMed] [Google Scholar]
  45. Silk D. B., Rees R. G., Keohane P. P., Attrill H. Clinical efficacy and design changes of "fine bore" nasogastric feeding tubes: a seven-year experience involving 809 intubations in 403 patients. JPEN J Parenter Enteral Nutr. 1987 Jul-Aug;11(4):378–383. doi: 10.1177/0148607187011004378. [DOI] [PubMed] [Google Scholar]
  46. Solomon S. M., Kirby D. F. The refeeding syndrome: a review. JPEN J Parenter Enteral Nutr. 1990 Jan-Feb;14(1):90–97. doi: 10.1177/014860719001400190. [DOI] [PubMed] [Google Scholar]
  47. Tapia J., Murguia R., Garcia G., de los Monteros P. E., Oñate E. Jejunostomy: techniques, indications, and complications. World J Surg. 1999 Jun;23(6):596–602. doi: 10.1007/pl00012353. [DOI] [PubMed] [Google Scholar]
  48. Vanlandingham S., Simpson S., Daniel P., Newmark S. R. Metabolic abnormalities in patients supported with enteral tube feeding. JPEN J Parenter Enteral Nutr. 1981 Jul-Aug;5(4):322–324. doi: 10.1177/0148607181005004322. [DOI] [PubMed] [Google Scholar]
  49. Wicks C., Gimson A., Vlavianos P., Lombard M., Panos M., Macmathuna P., Tudor M., Andrews K., Westaby D. Assessment of the percutaneous endoscopic gastrostomy feeding tube as part of an integrated approach to enteral feeding. Gut. 1992 May;33(5):613–616. doi: 10.1136/gut.33.5.613. [DOI] [PMC free article] [PubMed] [Google Scholar]
  50. Windsor J. A., Hill G. L. Risk factors for postoperative pneumonia. The importance of protein depletion. Ann Surg. 1988 Aug;208(2):209–214. doi: 10.1097/00000658-198808000-00013. [DOI] [PMC free article] [PubMed] [Google Scholar]
  51. Winterbauer R. H., Durning R. B., Jr, Barron E., McFadden M. C. Aspirated nasogastric feeding solution detected by glucose strips. Ann Intern Med. 1981 Jul;95(1):67–68. doi: 10.7326/0003-4819-95-1-67. [DOI] [PubMed] [Google Scholar]
  52. Woolfson A. M., Saour J. N., Ricketts C. R., Pollard B. J., Hardy S. M., Allison S. P. Prolonged nasogastric tube feeding in critically ill and surgical patients. Postgrad Med J. 1976 Nov;52(613):678–682. doi: 10.1136/pgmj.52.613.678. [DOI] [PMC free article] [PubMed] [Google Scholar]
  53. Wyler A. R., Reynolds A. F. An intracranial complication of nasogastric intubation. Case report. J Neurosurg. 1977 Aug;47(2):297–298. doi: 10.3171/jns.1977.47.2.0297. [DOI] [PubMed] [Google Scholar]

Articles from Postgraduate Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES