A prospective study of tube- and feeding-related complications in patients receiving long-term home enteral nutrition

Objectives: Percutaneous endoscopic gastrostomy tubes are frequently inserted to facilitate long-term enteral nutrition. There are few studies that address long-term complications related to feeding tubes. The purpose of this study is to examine the long-term complications related to tube malfunction and the effect these have on health care use. Methods: In this prospective study, 8 patients who were discharged home on long-term home enteral nutrition completed a diary that listed 17 potential complications related to enteral feeding devices. Subjects completed the diary on a weekly basis, noting which of the potential complications they were experiencing and the intervention related to that complication. Results: The 8 patients were followed for a mean of 10.5 months. Common tube-site complications included discharge from the tube site, red or tender stoma, and granulation tissue. Mechanical problems related to tubes plugging, breaking, and falling out were also common. Despite having a dedicated nurse and dietitian to follow these patients, unscheduled health care contacts were frequent and averaged 5.4 contacts over the mean follow-up-time of 10.5 months. Conclusions: In patients receiving long-term home enteral nutrition, tube and tube-feeding complications are frequent and result in significant health care use. Given the increasing use of long-term enteral nutrition, strategies and programs must be developed to assist patients and their families in managing these complications.