Advantages and Disadvantages of Enteral Feeding Routes
Feeding Route Characteristics
Nasogastric
Characteristics of the nasogastric
feeding route include its use of a tube
inserted through the nose and into the
stomach to deliver nutrition. It is
commonly used when the oral route of
feeding is insufficient or unsafe.
Nasoduodenal or Nasoduodenal and nasojejunal feeding
nasojejunal routes involve inserting a tube through
the nose to deliver nutrition directly into
the small intestine, bypassing the
stomach.
Gastrostomy or PEG Gastrostomy or PEG feeding routes are
commonly used for enteral feeding
when oral intake is insufficient or not
possible. It involves surgically creating
an opening (stoma) directly into the
stomach through the abdominal wall,
allowing for the insertion of a feeding
tube.
Jejunostomy or PEJ Jejunostomy or PEJ feeding routes are
enteral feeding methods used when
Advantages
Advantages of nasogastric tube feeding
include its safety and effectiveness in
delivering enteral nutrition. It is a
relatively low-risk method compared to
parenteral nutrition, which involves
intravenous delivery. Nasogastric feeding
also helps prevent gut atrophy and
reduces the risk of infection. Moreover, it
is a cost-effective option in comparison to
other feeding methods.
These routes can benefit individuals with
difficulty tolerating gastric feeding, reduce
the risk of reflux, and decrease the risk of
aspiration.
Gastrostomy is a durable and
long-lasting feeding method that is
suitable for patients who require
extended enteral feeding support. It
Improved patient comfort. Easier
administration of medications:
Gastrostomy tubes can also be used for
the administration of medications, as they
provide direct access to the stomach.
Bypasses the stomach and duodenum:
Jejunostomy feeding bypasses the
Disadvantages
The presence of a nasogastric tube can
cause discomfort, and some individuals may
experience nasal irritation or sore throat.
Proper care and attention are required to
maintain the tube's integrity and prevent
complications such as tube dislodgement or
blockage. Additionally, nasogastric feeding
may not be suitable for individuals with
certain conditions or anatomical
abnormalities.
Increased tube length: Advancing the tube
to the jejunum requires a longer tube length,
which may increase the risk of
complications such as tube displacement or
blockage. Adjustments in tube placement:
Accurate placement verification is required
to ensure the tube is in the jejunum, which
may involve radiographic imaging.
Gastrostomy tube placement requires a
minor surgical procedure, which carries the
risks associated with any surgical
intervention, such as infection or bleeding.
Compared to non-surgical feeding methods,
gastrostomy tubes may require a longer
recovery time after placement. It exits
through the abdominal wall, which can have
implications on body image and
psychological well-being.
Surgical procedure: Jejunostomy tube
placement requires a surgical procedure,
 gastric feeding is not feasible or
tolerated. Jejunostomy feeding involves
creating a surgical opening (stoma)
directly into the jejunum, the second
part of the small intestine, allowing for
the insertion of a feeding tube.
Administration of Enteral Tube Feedings
Method Indications
Continuous
Patients unable to tolerate large volume
feedings: Continuous feeding allows for
smaller, frequent feedings that are better
tolerated by individuals who cannot
tolerate large volumes of food at once.
Continuous enteral feeding bypasses the
stomach and allows for direct delivery of
nutrients to the small intestine, making it
suitable for patients with delayed gastric
emptying or motility issues. Patients
requiring precise control: Continuous
feeding is beneficial for patients who
need precise control over their nutrient
intake, such as those with specific
dietary restrictions or those requiring
precise medication administration.
stomach and duodenum entirely, making
it suitable for patients with gastric motility
issues, gastric intolerance, or those at a
high risk of aspiration.
Improved nutrient absorption: The
jejunum is an ideal site for nutrient
absorption, offering enhanced nutrient
delivery compared to gastric
feeding.Simultaneous gastric
decompression: Jejunostomy tubes can
be used for both enteral feeding and
gastric decompression if necessary.
Advantages
Improved nutrient absorption and utilization: such as infection, blockage, or reflux may
Continuous enteral feeding ensures a
consistent supply of nutrients, enhancing
absorption and utilization by the body.
Reduced risk of gastrointestinal
complications: By mimicking a more natural formulas, and accessories. This may
feeding pattern with smaller, frequent
feedings, continuous feeding can help
reduce the risk of complications like
bloating, distension, and diarrhea.
Enhanced patient comfort: Continuous
feeding can be more comfortable for
patients compared to bolus feeding, as it
reduces the sensation of fullness and
discomfort associated with large-volume
feedings.
which carries the typical risks associated
with surgery, such as infection, bleeding, or
damage to surrounding structures. Longer
recovery time: Compared to non-surgical
feeding methods, jejunostomy tubes may
require a longer recovery time after the
placement procedure. Complex placement
and maintenance: Jejunostomy tubes are
more technically challenging to place and
maintain, requiring specialized expertise.
Disadvantages
The risk of dislodgement or complications
be higher compared to intermittent or
bolus feeding methods. It typically
necessitates the use of a feeding pump
and continuous supply of feeding bags,
increase resource requirements and
costs. And patients on continuous enteral
feeding may experience reduced mobility
and require the use of a pump or other
equipment, which can impact their daily
activities and quality of life.
Intermittent - Intolerance to bolus - Feeding pump may not be required - Increased risk for aspiration
administration - May enhance quality of life - Gastric distention
- Initiation of EN without feeding - Allows greater mobility between - Delayed gastric emptying
pump feeding
- May be better tolerated than bolus
feeding

Bolus - Recommended for gastric - More physiological - Increased risk of aspiration

feeding - Feeding pump not required - Hypertonic, high-fat, or high-fiber
- Normal gastric function - Inexpensive and easy formulas may delay gastric
administration emptying or result in osmotic
- Patients is free to move about, diarrhea
participate in rehabilitation
therapies, and live a relatively
normal life
- And more likely patient will receive
all of formula