Complex Nutrition

If you are in hospital to have an operation and you are malnourished, you may be offered different foods and drinks to improve your diet.   If you are malnourished and you are having an operation on your stomach or intestine – you may be given a liquid feed through a tube before your operation. This type of feeding is called enteral feeding and is described in more detail below.

If you can’t eat and drink normally or you are not able to take in enough nutrients, you may be offered a liquid diet through a tube into your gut. This is called enteral feeding.  Enteral feeding is when you are able to take in your nutrition support orally.

Usually a feeding tube is inserted into your nose and is passed down into your stomach. This tube is called a nasogastric tube (NG tube).  It is connected to a container of liquid feed. This feed can be given continuously or in fixed doses depending on your needs. This liquid feed should contain all of the nutrients needed by your body. If your stomach isn’t working properly the tube is passed down into your small intestine instead.

If you need enteral feeding for more than 4 weeks you may be offered a different feeding tube; this is called a gastrostomy or a PEG (percutaneous endoscopic gastrostomy) tube or a jejunostomy tube.

A PEG tube is inserted through your abdomen into your stomach and can make enteral feeding easier and more comfortable. A jejunostomy tube is inserted directly into the jejunum (which is part of your small intestine). This means the feed doesn’t go into the stomach and is given directly into the small intestine.

Parental Nutrition (PN) is given intravenously, directly into the bloodstream of a patient.

If you can’t be fed by a tube into your stomach or intestine you may be offered a sterile liquid feed through a tube into your blood. This is called parenteral feeding.

Parenteral nutrition is the​​​ feeding of nutritional products to a person intravenously, bypassing the usual process of eating and digestion.

A narrow tube known as a catheter is placed in a vein. This is connected to a container of sterile liquid feed. This sterile liquid feed should contain all of the nutrients needed by your body. The standard mixture of nutrients should be adjusted to suit your needs. For example, you may need additional vitamins to be added. The feed is introduced gradually. It can be given continuously or in cycles depending on your needs.

The Nutrition Nurses will check on improvements in your nutrition regularly. Once you are able to absorb nutrients and be fed by a tube into your gut, or eat normally, parenteral feeding will be stopped gradually.

As part of a Multi-Discioplinary Team (MDT) we manage all aspects of Parenteral Nutrition (PN) in the Trust. The MDT includes Gastroenterologists, Specialty Pharmacists and Specialty Dietetics.

An IV infusion consists of various bits of equipment joined together. The first bit is a cannula (thin, plastic tube) which is put into a vein, usually in the hand or arm. The cannula is then connected to a longer, wider tube which, in turn, is joined to a bag containing the fluid or medicine.

Magnesium Sulfate (our most common infusion) is used to treat low levels of magnesium in the blood where it is not possible for medicine to be taken orally.

If you are having enteral or parenteral feeding at home, you will be supported by a team of healthcare professionals. This team can be made up of your GP, District Nurses or other types of Homecare Nurses, Dietitians and specialists such as Speech and Language Therapists. They will work with you and your carer to make a care plan suited to your needs. This plan will cover how much feed you need, what it will be made up of, when you will receive it and how your nutrition will be monitored.

Special equipment will need to be set up in your home. You and your carer will given training on how to use it. You will be given details about delivery of the equipment, the feed and anything else you might need, including contact details for the company supplying it (Nutricia).  You will be given information on:

• your feeding regimen
• procedures for the feed
• common problems and how to deal with them
• how to use the equipment.

You will also be given telephone numbers to ring if you have any questions, as well as numbers to call in an emergency.

Percutaneous endoscopic gastrostomy (PEG)

Freka Percutaneous Endoscopic Colostomy (PEC) aftercare sheet

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Nutricia Homeward Enteral Nurse 

White Horse Business Park, Trowbridge, Wiltshire BA14 0XQ

Tel: 03457 623648

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