[5][6] Feeding tubes can also increase the risk of pressure ulcers, require pharmacological or physical restraints, and lead to distress.

360ee (b) (3)) as "a food which is formulated to be consumed or administered enterally under the supervision of a physician and which is intended for the specific dietary management of a disease or condition for which distinctive nutritional requirements, based on recognized scientific principles, are established by medical evaluation.

The primary advantage of the NG-tube is that it is temporary and relatively non-invasive to place, meaning it can be removed or replaced at any time without surgery.

[21] More specifically, when nasogastric or nasoenteric tubes are placed incorrectly, they can damage patients' vocal cords, lungs, or trachea, resulting in serious injuries or even death.

The suture is then tied to the end of the PEG tube that will be external, and pulled back down through the esophagus, stomach, and out through the abdominal wall.

The G-tube can be useful where there is difficulty with swallowing because of neurologic or anatomic disorders (stroke, esophageal atresia, tracheoesophageal fistula, radiotherapy for head and neck cancer, etc.

[26] A G-tube may instead be used for gastric drainage as a longer-term solution to the condition where blockage in the proximal small intestine causes bile and acid to accumulate in the stomach, typically leading to periodic vomiting, or if the vagus nerve is damaged.

[27][28] A gastrojejunostomy, or GJ feeding tube, is a combination device that includes access to both the stomach and the jejunum, or middle part of the small intestine.

The GJ-tube is used widely in individuals with severely impaired gastric motility, high risk of aspiration, or an inability to feed into the stomach.

Research suggests that the best course of treatment for patients with a gastric tube is periodic professional cleaning, maintained with routine home use of a non-foaming anti-calculus dentifrice (toothpaste).

[36] Dental caries is a localized disease in which susceptible tooth structure is broken down by bacteria that are able to ferment carbohydrates into acid.

Although it has not been extensively studied, researchers speculate that individuals fed by tube may be less prone to the development of caries as they are not exposed to carbohydrates orally.

[35] Dental erosion is the dissolution of the tooth's hard structures (enamel, dentin & cementum) by exposure to acids not caused by bacteria.

Gastroesophageal reflux disease (GERD) affects up to 67% of children and young adults with central nervous system dysfunction, a condition which in itself is normally an indicator for tube feeding.

Firstly, undisturbed plaque is known to shift towards the type of bacteria (Gram-negative anaerobic) implicated in aspiration pneumonia.

Additionally, tube-fed patients are commonly affected by gastroesophageal reflux and a breakdown in the airway protection reflex (breathing while swallowing).

This can also lead to dysphagia (difficulty swallowing), muscle weakness and improper airway protection, resulting in longer periods of tube-feeding and increased risk of dental complications.

A dentist may prescribe a "desensitization program", which involves routine stimulation of intra-oral and extra-oral structures, and encourage oral hygiene procedures to be performed at home.

[35] While enemas were previously used for supplemental enteral nutrition, the practice of surgically inserting feeding tubes emerged in the mid to late 1800s.