Table of Contents
Introduction
Many patients, mainly elderly and severely diseased individuals, suffer from difficulty eating and digesting food. On these occasions, the supply of artificial nutrients to the body becomes obligatory. Such nutrition is formulated by considering the right balance of all essentials: fats, proteins, sugars, vitamins, and minerals. The parenteral and enteral nutrients are delivered into the body through absorption into the gut in the usual way (enteral) and by an intravenous stream bypassing the gut directly into the bloodstream.
What Is Enteral Nutrition?
This route of nutrition is adapted when the intestines work well to absorb food and derive nutrition from it. While enteral nutrition can be delivered by mouth, in many cases, nutrition is delivered into the intestines by using nutrition tubes.
1. Enteral Nutrition Via Mouth
This type of enteral supply of nutrition is provided to patients who cannot eat and chew food because of poor appetite or difficulty chewing the food. This nutrition supply is also recommended for patients needing extra nutrition due to illness. Such nutrition is given to the patients through the mouth, either in the form of drinks or eatables, in addition to the food they eat, giving them extra energy. This gives an energy boost to patients who demand fast and large amounts of nutrition when they cannot take large meals.
2. Enteral Nutrition by Tube
This method delivers nutrition to the intestines or gut through tubes. This method is used for patients who cannot consume nutrition through the mouth due to an inability to function or difficulty swallowing food, but the gut is functioning well.
The tube can be incorporated into the digestive system at various levels, which are known by the following -
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Nasogastric Tube (NGT) - This tube is inserted into the nostrils up to the stomach.
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Orogastric Tube (OGT) - This tube is inserted through the mouth and up to the stomach.
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Nasoenteric Tube - This type is inserted through the nostrils and ends at the jejunum (the middle part of the intestine) level or the duodenum (the starting point of the intestine). Sometimes, the tube is inserted directly from the abdomen into the stomach or intestines.
This includes :
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Gastrostomy - The method of inserting the feeding tube through the abdomen into the stomach.
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Jejunoscopy - The tube is inserted through the abdomen right into the intestine at the level of the jejunum.
What Is Parenteral Nutrition?
The parenteral nutrition method is used when the stomach and intestines cannot absorb nutrients. In such circumstances, the nutrients are delivered directly into the patient's bloodstream so they can utilize them for the body's functioning.
Parenteral nutrition can be of the following types -
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Intravenous - This is a method of inserting the nutrients directly into the bloodstream through the venous circulation. This technique is utilized when the rapid onset of action is required quickly.
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Intramuscular - This method involves administering the drugs intramuscularly, where the drug dissolves slowly into circulation. The onset of action is slow in this route of nutrition.
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Subcutaneous - This route of nutrition is adapted when the molecular size of the medication or the nutritional substances is large enough to get readily absorbed by the intestines. This method is easy to administer, and the patient can self-administer this technique of taking up the nutrition.
What Are the Reasons for Enteral Nutrition Feeding?
Enteral nutrition may become a priority if someone cannot meet the calorie deficit. This can happen due to a physical disability that prevents an individual from eating. Some common reasons why the need for enteral nutrition arises are -
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If a person suffers from a stroke, it may hamper his ability to swallow. In such cases, this route for nutrition may be considered.
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In the case of cancer patients who feel fatigued, waves of nausea and vomiting can cause difficulty swallowing.
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Head injuries or other critical injuries that reduce the ability to move or chew.
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The children who fail to thrive.
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In the case of serious illness, the body experiences stress and cannot take optimum nutrition.
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Due to increased demand, people with neurological disorders or movement disorders have an increased calorie deficit; in such cases, the enteral route of nutrition can be used.
What Are the Reasons for Parenteral Nutrition?
This type of feeding is included when the patient's gut cannot function. The reasons parenteral nutrition is taken up are -
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If any obstruction in the stomach or intestines causes an inability to function, parenteral nutrition is chosen.
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In perforation or gut ulceration cases, feeding can worsen infections, so the intestines are bypassed and nutrients are delivered directly into the systemic circulation.
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When a large part of the gut has been removed, the patient cannot absorb enough food; at this point, the parenteral route is adapted.
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In some diseases, such as functional short bowel conditions, some parts of the intestines are diseased and unable to function correctly. In such cases, nutrition is obtained through the parenteral route.
Conclusion
Generally, enteral nutrition by mouth is preferable to parenteral nutrition because it is simpler and psychologically more psychological. However, the enteral route through tubes needs more intervention; parenteral nutrition is preferred. In many situations, the parenteral route can be a life-saving option. Enteral and parenteral nutrition can have unique complications. Some complications can be aspirations while the person is unconscious. At that point, the parenteral method has to be used. On the other hand, the parenteral route needs skillful handling. Hence, the route that can be taken solely depends on the circumstances, the patient's body, and the type of the disease. Both are beneficial for the patient’s health.
