Hi, I’m Makenna and I’m here to talk to you about Feeding Tubes. In my experience, they are something not a lot of people know about and I want to change that.

Where and how feeding tubes can be placed:

There are three places a feeding tube can be placed but two methods for placing the tube into the patient. The two placement methods are: surgical or “naso-gastric” which means the tube enters through the nose (from the nostril down the throat). Either of these placement methods can be used to get a tube into one of three locations along the digestive tract.

The first location a tube can be placed is in the stomach; this is the most common. The second is the duodenum (the first part of the small intestine). The last placement for a feeding tube is the jejunum (the second part of the small intestine; between the duodenum and ileum). The two types of tubes that are placed surgically are in the stomach and the jejunum. A duodenum tube is not normally placed surgically but can be if needed for the patient.

When a tube is placed through the nose (a naso-gastric or NG tube) it goes down into the throat and along the esophagus into the stomach, or further down into the duodenum or jejunum. NG tubes can be placed by a care provider, or also by a patient once they have been trained on how to do it. When a tube is placed surgically the surgeon will make an incision directly into the places or place needed for the tube.

How and why feeding tubes deliver nutrition:

When you receive nutrients through a feeding tube it’s called “Enteral Nutrition.” There are two types of feedings in the enteral feeding family. These are known as exclusive enteral nutrition (EEN) and partial enteral nutrition. When someone is doing EEN, it means they aren’t eating anything by mouth and sometimes even not drinking by mouth either. Feedings can also be partial; used as needed or along with some eating by mouth. Partial enteral nutrition is used pretty much as a nutrient boost and to help patients keep weight on while still eating small amounts of food by mouth. The reason your doctor might choose to do EEN instead of using tube feedings to supplement nutrition is to give your digestive system a complete break from digesting food, which can help calm inflammation.

Ending the stigma around feeding tubes:

One of the biggest cons of tube feeding is the stigma around feeding tubes. People with feeding tubes are told so often that they are unhealthy because they have a feeding tube. Any person I have met that has a feeding tube would tell you that their tube is the reason they are becoming healthy. Yes, they may have been unhealthy before, but because of their feeding tube they are able to live. There are so many reasons feeding tubes are used. Some examples include eating disorder recovery, cancer treatment to help with nutrition, and as we're talking about today - digestive disorders. The saddest part of having a feeding tube, from my own experience, is the staring and the rude comments there. There is a difference between rude comments and being curious and asking questions. If you are rude and asking without the goal of really learning about their experience, they might not want to answer your question. If you ask a question respectfully, they will pretty much answer the questions within reason.

Body image, mental health and feeding tubes:

The last topic I want to talk about is body image and depression within the feeding tube community. With the joys and relief of a having a feeding tube, inevitably comes unwanted remarks and attention from other people. This can include rude comments, staring, questions about weight and comments about how a body looks. When a person starts tube feeding, they will most likely gain weight very quickly, which is one of the big reasons for this treatment plan. With weight gain, especially with girls, comes body image issues. When weight is gained fast it can cause the body to appear very different. A person can go from a ‘skin and bones’ look to having a stomach that isn't the flattest. It can be hard to remember these dramatic changes are normal and even healthy, and when these changes are focused on by others it can be hard to ignore.

Depression can also happen when a person is living with a feeding tube. Having to cancel plans a lot due to not feeling well can lead to feeling like a burden to friends and family. For me personally, depression episodes led to self-harm, addiction to harmful substances, and suicidal thoughts. It took many years for me to realize my doctors were trying to help me feel and get better. It was so hard to live with a chronic illness where my weight was so different all the time. With the help of mental health professionals, and medications to treat me, I am now in a better headspace. People with any type of chronic illness, feeding tube or not, have to realize it's okay to let people know that you're not okay and that you need help.

People with feeding tubes are not any different than anyone else in this world. Feeding tubes make a patient stronger and able to fight their battles. Yeah, there are many cons that come with having a feeding tube, but tubes of any type have so many ways of making patients love their life. People don't choose to have feeding tubes, but they can choose the attitude they have while being tube fed.

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Note: if you are seeking additional information about feeding tubes and the role they may play in your IBD care, we recommend continuing the conversation with your IBD care team.

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