What is Nutrition Support?
All humans require food and nutrients to live and carry out the essential functions. In situations where the stomach or intestine is not functioning appropriately, nutrition must be supplied through a different method, as oral intake may not be the best strategy. Nutrition can be provided either through a feeding tube (enteral nutrition) or when the digestive tract cannot be used, through an intravenous catheter that is inserted directly into the veins (parenteral nutrition). The amount, type and route of nutrition are tailored specifically to each patient with the goal being to improve patient outcomes, minimize infections and allow patients to live their lives as normally as possible.
Home Parenteral Nutrition (HPN)
Parenteral nutrition refers to feeding intravenously or through a vein. Patients are generally started on parenteral nutrition (PN) in hospital. If it is believed that PN needs to be continued beyond the hospital stay, patients may be discharged home on PN. In this situation, there is a clinical need for long term PN. The length of HPN can be quite variable and depends on the underlying disease, the indications for HPN, and factors that may be modifiable over time such that PN may eventually be discontinued. HPN is only recommended if the gut cannot be used usually due to intestinal failure. There are some other very specialized indications for HPN that the nutrition support team will evaluate for if necessary. HPN or PN in general is never appropriate in the context of a functioning gut, or because a feeding tube is simply not desired. HPN therapy is complex and costly. Patients and family members need to be taught proper technique in hospital, and be able to demonstrate their skills prior to discharge home. HPN is not without complications, which are listed below.
Home Enteral Nutrition (HEN)
HEN is provided through a feeding tube. Tubes can be placed through the nose into the stomach or small bowel. This tube is called a nasogastric (NG) or nasoenteral feeding tube. Sometimes the tube is placed through the skin into the stomach or small bowel. This is called a gastrostomy or jejunostomy. There are different methods of insertion for the tubes available. Similarly, there are multiple enteral formulas that are available. Your nutrition support team will advise and assist with the appropriate feeding tube and formula.
To read about the Southern Alberta Parenteral and Enteral Home Nutrition Program, click here.