How do feeding tubes work? What cancer patients and caregivers should know

Maintaining proper nutrition during cancer treatment is important. When cancer patients struggle with this, a feeding tube can help. These flexible, plastic tubes placed in the stomach or small intestine can help provide the calories, protein, vitamins, minerals and fluids needed to help the body fight infection, heal and stay healthy.

Even though a feeding tube may be needed to help you maintain a healthy, active life during and after cancer treatment, it can be a big change.

We asked senior clinical dietitian Daxaben Amin what cancer patients and caregivers should know about feeding tubes.

When do cancer patients need a feeding tube?

Cancer patients may need a feeding tube if they:

• have trouble swallowing due to cancer in the head or neck area;
• are malnourished before or during cancer treatment, including surgery, chemotherapy and radiation therapy; and/or
• have fistulas or an abscess in the esophagus or stomach.

How is a feeding tube inserted?

The way a feeding tube is placed depends on the type of feeding tube you need. There are four types of feeding tubes commonly used:

Nasogastric tube (NG-tube)

This flexible tube is passed through the nose, down the esophagus and into the stomach. It is placed at the patient’s bedside in the hospital and doesn’t require a surgical procedure. It is often temporary and given to patients who can’t eat for a short period before, during or after cancer treatment.

Nasojejunal tube (NJ-tube) 

This soft, thin tube is inserted through the nose, goes through the stomach and ends in the small intestine. It’s usually placed as an inpatient procedure. Patients have this feeding tube temporarily. It’s often used for patients who cannot have a feeding tube placed in their stomach due to persistent vomiting or other medical conditions.

Gastrostomy tube (G-tube)

This tube is inserted through the belly and brings food directly to the stomach. It can be placed during an outpatient procedure and does not require an overnight stay. This tube is often used when patients will need a feeding tube for three to four months or longer. It’s very easy to use.

Jejunostomy tube (J-tube)

A J-tube is a soft, plastic tube placed through the skin of the belly into the midsection of the small intestine. It can be placed during an inpatient or outpatient procedure. The tube delivers food and medicine until the person is healthy enough to eat by mouth. It bypasses the stomach completely and is often used when the patient cannot digest food in the stomach, like in some cases of esophageal cancer or stomach cancer. This tube is also best for long-term use.

How does a feeding tube work?

Different feeding tubes work in different ways.

Feeding tubes placed in the small intestine, like the NJ-tube and the J-tube, use a pump – typically formula.

Others, like the NG-tube and G-tube, rely on gravity or a syringe to push the food.

Your care team will teach you how to use your specific feeding tube.

Are feeding tubes painful?

Patients with an NG-tube or NJ-tube may feel some irritation in their nose where the tube is inserted. The good news is that these tubes are only used for a few days or weeks.

Patients may experience initial pain and discomfort with the longer-term tubes, like G-tubes and J-tubes. Typically, it may feel a little sore in the area near the tube for the first two or three days. After that, the soreness should go away.

Can patients operate feeding tubes by themselves?

Yes, all four types of the common feeding tubes mentioned above can be operated by patients. But depending on their physical and mental health, some may need help from a caregiver or health care provider.

At MD Anderson, our nurses will provide classes in the patient's room to prepare them to use feeding tubes before they discharge. We also offer online resources that show how to use feeding tubes. 

What kind of food goes into a feeding tube?

The only foods that should go into the feeding tube are commercial formulas specially made for feeding tubes. Using other foods could degrade or lower the quality of the feeding tube and increase a patient’s risk for infection.

Can patients still eat if they have a feeding tube?

Yes, patients can eat by mouth while they have a feeding tube as long as they do not have dysphagia, or difficulty swallowing.

Once you start eating 60% to 75% of your calories and protein by mouth, your dietitian may tell your doctor that it’s safe to remove the feeding tube. At that point, you’re getting most of your nutrients by mouth, so the feeding tube is no longer needed. 

How long can patients stay on a feeding tube?

The NG-tube and NJ-tube are meant for short-term use, about four to six weeks. The G-tube and J-tube are used long-term. 

Are there any side effects from using a feeding tube?

Usually, there are no side effects from the tube itself. Some patients may experience some nausea, vomiting or diarrhea, but we can help you manage this by adjusting how much formula is given and how much time the feeding takes. If these side effects continue, your doctor can prescribe anti-nausea or anti-diarrheal medicine.

It’s also important to follow your care team's instructions for cleaning the feeding tube and the area surrounding it. If the feeding tube isn't cleaned properly, that puts the patient at risk of infection. If a patient has an infection, the skin around the feeding tube will look red and swollen.

How can patients cope with feeling self-conscious about using feeding tubes?

Feeding tubes are very easy to hide under clothes. Many patients go back to work after having a feeding tube installed, and their co-workers have no idea they have a feeding tube.

With closer family and friends, we recommend talking to them about your condition and showing them how the feeding tube works. If you’re comfortable, get your caregiver involved, and teach them how to use the feeding tube. A straightforward approach is typically best.

Request an appointment at MD Anderson online or call 1-877-632-6789.