Ruwaida Dhala, MSc, BSc
Patients with advanced dementia often develop eating difficulties and undergo weight loss.1 In order to sustain ongoing nutrition in these patients the question of using enteral feeding can be raised. Although benefits of enteral feeding are still largely unclear, there is an increasing frequency of its use especially in patients with dementia.2 This article will examine the risks of this procedure in order to identify whether enteral feeding is necessary and beneficial in all cases.
Long term enteral feeding commonly involves the administration of nourishment through a tube that is put directly into the stomach (percutaneous endoscopic gastrostomy tube). Enteral tube feeding is regarded as a safe, efficient and inexpensive method of feeding patients who have difficulty swallowing. Although enteral feeding is widely used, there is evidence that points to the negative effects of enteral feeding. Proponents of enteral nutrition usually identify its benefits as prevention of aspiration pneumonia, reducing risks of infection and prolonging survival.1 However artificial feeding carries risks which include aspiration, infection, fluid overload, removal of the tube by the patient, and overall patient discomfort.2
A 1996 review looking at the use of tube feeding to prevent aspiration pneumonia found that there is no evidence to support this.
