Enteral nutrition (EN) means delivering nutrition through the GI tract — specifically via a tube that bypasses the need to swallow. It is distinct from parenteral nutrition, which is delivered intravenously and bypasses the gut entirely. “If the gut works, use it” is a clinical principle: enteral feeding preserves gut barrier function, reduces infection risk, and is safer and more physiologically appropriate than parenteral routes.
Indications include: dysphagia (post-stroke, head and neck cancer), severe swallowing impairment in neurological disease, inadequate oral intake post-surgery, critical illness in ICU, and conditions causing severe anorexia where oral supplementation is insufficient.
Route depends on the expected duration and clinical situation. Short-term feeding (days to weeks) typically uses a nasogastric (NG) tube — passed through the nose into the stomach. For longer-term feeding, a percutaneous endoscopic gastrostomy (PEG) tube is placed directly through the abdominal wall into the stomach.
Formula selection is complex: standard polymeric formulae suit most patients; disease-specific formulae exist for chronic kidney disease, diabetes (lower glycaemic formulas), and surgical immunonutrition. Volume, rate, and timing of feeds are individually calculated by a dietitian based on energy, protein, and fluid needs.
Complications — tube displacement, aspiration, diarrhoea, overfeeding, and refeeding syndrome in at-risk patients — require careful monitoring. Enteral nutrition must be prescribed and supervised by a registered dietitian working within a clinical team.