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Providing adequate nutrition remains a fundamental component of health care. Without proper nutrition, hospitalizations may be prolonged, disease states may be undertreated and clinical outcomes may be less than optimal. In one study[1] of hospitalized patients, up to 50 percent were considered malnourished. Most of these patients were elderly or had one or more chronic diseases. Because of the growing number of elderly patients and an increasing need for nutritional supplementation in many of them, the knowledge base of the primary care physician must include familiarity with enteral feeding.

Enteral nutritional therapy includes both oral supplementation and tube-feeding techniques. Tube feedings may be delivered through nasogastric, nasojejunostomy, gastric or jejunostomy tubes. Several factors must be considered when deciding which route of feeding to use. Of particular importance are the aspiration potential of the route of administration and the anticipated duration of the enteral therapy. When using feeding tubes, several schedules of administration may be considered, including continuous infusion and multiple bolus feedings.

Indications

The primary indication for nutritional therapy is inadequate protein and caloric intake over an extended period of time. The choice of enteral versus parenteral support should be based on the axiom "if the gut works, use it." If the patient is eating, oral supplementation should be selected. If the patient cannot eat or cannot swallow adequately, or if oral supplementation is not successful, an enteral feeding tube should be considered.

In 1987 the American Society of Enteral and Parenteral Nutrition (ASPEN) published guidelines for the use of enteral nutrition, which include the clinical settings in which enteral nutrition is helpful, the clinical settings in which it is of limited value and the settings in which it is contraindicated (Table 1).[2] The guidelines are intended to be applied to patients who cannot ingest adequate amounts of nutrients orally but can use their gastrointestinal tracts safely and effectively  Medical Supply

Intestinal Nutrition, Nutritional Supplements, Food Thickener, Enteral Feeding, Enteral Feeding Pump.