There are two main types of nutritional support. We explain them here.
Enteral nutrition (EN)
This is where the nutritional fluid or feed is given into the gut, through a tube going into the stomach or small intestine. This is often called tube feeding.
EN works best if your digestive system is working normally but you are not able to eat or drink enough, for example because of a cancer in the head or neck area.
There are several ways of giving EN. These are the most common:
- Nasogastric feeding (NG feeding) – a thin tube is passed down the nose and into the stomach.
- Percutaneous endoscopic gastrostomy (PEG feeding) and radiologically inserted gastrostomy feeding (RIG feeding) – a tube is passed through the skin and muscle of the tummy (abdomen) into the stomach.
- Percutaneous endoscopic jejunostomy feeding (PEJ feeding) – a tube is passed through the skin and muscle of the tummy (abdomen) into the middle of the small bowel (the jejunum) just below the stomach.
Tube feeding through NG, PEG or RIG is often used after surgery to the head, neck, stomach or gullet (oesophagus). There can be other reasons for using feeding tubes.
Parenteral nutrition (PN)
This is where the nutritional fluid is given through a tube that is put into a vein (intravenously). PN gives nutritional support when you can’t take nutrients in through your digestive system.
PN is usually used if people are unable to have EN, for example if a person has had surgery on the small bowel or has a bowel obstruction. It may also be used if it is difficult to insert the tubes used for EN. This can happen after some types of surgery to the head, neck or stomach.