Gastrostomy Tube Feeding and Management in the Community

Abstract

HO YU-LING Medical Student Yong Loo Lin School of Medicine National University of Singapore ABSTRACT Gastrostomy tube feeding is the preferred method of long-term feeding for individuals who are not able to maintain adequate oral intake due to dysphagia or other underlying medical conditions. Family physicians may come into contact with patients who are on gastrostomy tube feeding in the inpatient, outpatient or community settings. As such, it is important to understand its indications and contraindications, complications and general management. The Home Ventilation and Respiratory Support Service in Tan Tock Seng Hospital manage patients on long-term invasive or non-invasive ventilation in the community who may also require gastrostomy tubes due to their underlying disease, and also does gastrostomy tube change in the home setting where appropriate. In this article, we review the indications and contraindications for gastrostomy insertion and the types of gastrostomy tubes available. We review the evidence for gastrostomy feeding compared to other modes of enteral feeding, namely nasogastric tube feeding, which is the most widely-used form of enteral feeding. Finally, we also cover current guidelines and recommendations for gastrostomy tube management in the community, such as tube change and complications, and selection of feeds.