Common Side Effects of Enteral Feeding and 7 Tips for Managing Them

Enteral feeding, enteral nutrition, or gastrostomy tube feeding (sometimes called g-tube feeding,) is commonly prescribed to people with injuries or healthcare conditions that make it difficult to chew or swallow. It involves using a special tube to deliver nutrition directly into the stomach or intestines. Tube feeding can help your loved one consume more calories, maintain their ideal weight, and receive essential nutrients. However, if done improperly, liquid meals can also lead to side effects.

To learn more about the potential side effects of enteral feeding (and how to prevent them), we spoke with California-based registered dietitian nutritionist Keirnin Harris. Below, Harris provides some simple tips and insights for keeping these symptoms at bay. 

Possible Complications of Enteral Feeding

Enteral feeding is usually safe and doesn't cause many problems, but it does have some risks, including:

• Aspiration (e.g., food getting into the lungs)

• Infection of the g-tube or insertion site

• Skin irritation

• Feeding tube dislodgement

• Feeding tube blockage

• Nausea

• Vomiting

• Bloating

• Diarrhea

• Constipation

Sometimes, enteral feeding causes refeeding syndrome –– which is a condition caused by an electrolyte imbalance.

How Can Parents and Caregivers Prevent or Manage Tube-Feeding-Related Side Effects?

There are various things you can do to prevent and/or manage enteral feeding side effects, including:

1) Administer Enteral Feedings In The Proper Position

“Make sure your loved one is sitting or lying at a 45-degree angle during tube feedings and for 30-60 minutes after feedings as well,” Harris said. “It’s even better if they’re sitting upright with their feet on the floor.” 

Good posture reduces the risk of choking and aspiration and makes digestion easier.

2) Never Rush Liquid Meals

Administering liquid meals too quickly increases the risk of bloating and diarrhea. 

Instead of rushing, set a timer and administer the liquid nutrition over 20-30 minutes, similar to how you might eat a regular meal. 

“If your loved one experiences gastrointestinal problems, like nausea frequently, gravity feedings or a pump might be gentler on their stomach,” Harris said. 

3) Don’t Use More Than One Formula

Once you choose a liquid formula that meets your loved one’s nutritional needs, keep buying it.

“Don’t switch enteral feeding formulas often,” Harris said. “It’s best to find a formula that works and stick with it. If the formula you use becomes unavailable, or your loved one experiences a change in their condition, meet with a registered dietitian or nutritionist. These [healthcare] professionals can recommend a new formula to start.”

4)  Watch Out For Constipation

Many people on liquid diets have constipation due to the lack of fiber. Fortunately, there are various over-the-counter medications and home remedies that can provide relief. 

“Constipation can be prevented with medicines such as senna, docusate, lactulose, reglan, and psyllium powder,” Harris said. “Sometimes, even prune juice is enough to provide relief. If your loved one goes more than a day without a bowel movement, contact their doctor.” 

5) Store Liquid Meals Properly

Many patients on enteral diets report symptoms like nausea and bloating. “If bloating occurs and your loved one has been on the same formula for a long time without complications, make sure to check the expiration date and review the storage instructions.”

Liquid nutrition must be kept at the proper temperature to prevent food poisoning. Though rare, it can occur. Follow the storage instructions on the packaging, and if you have any questions, contact your loved one’s primary healthcare physician or nutritionist.

6) Establish a Feeding Schedule

If you care for someone with a feeding tube, you don’t necessarily need to follow a traditional meal schedule. 

“Create a feeding schedule that works for you and your loved one,” Harris said. “Some caregivers prefer night feedings with a gravity pump, as they can free up time during the day. Others find that bolus feeding is more convenient.”

A dietitian or nutritionist can help you develop a personalized feeding schedule that allows your loved one to thrive.

7) Advocate for Your Loved One

Diet and nutrition are essential to your loved one’s health and well-being. So, it’s important to include them in your caregiving plan.

“Ensure there’s a registered dietitian on your loved one’s medical team. Someone who can regularly check their nutritional status, make feeding recommendations, and answer any feeding questions you have,” Harris said. “As a private practice and clinical dietitian, I am often contacted by doctors for tube feeding recommendations, questions, and concerns.”

Takeaways

Feeding tubes are incredible inventions that make mealtime much simpler, but they do come with certain risks.. By following the tips listed above, you can prevent complications and help your loved one stay healthy. 

Questions?

Have questions about tube feeding or need help selecting a catheter or syringe? Our Caregiving Specialists are standing by, ready to answer your questions. Call (800) 696-CARE or email support@carewell.com and they’d be happy to help you.