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Is it good to feed through a hole in the stomach for a patient admitted due to weakness in left half of body ?

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Internal Medicine Specialist
Practicing since : 1998
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Hi, My mum (over 70 years of age) has been admitted at Royal Hospital (Muscat) for over a week now. The half left side of her body is very weak (some people says it is a stroke, not sure) and she has high blood pressure. Since admitted she is being fed via a pipe in her nose, and most of the time is asleep for long hours ?. Now they want to make a hole in her stomach for feeding, is it good idea or she should be given some times and might recover? please advise. Thanks
Posted Tue, 1 May 2012 in General Health
 
 
Answered by Dr. Jasvinder Singh 2 hours later
Hello,
Thanks for posting your query. Three points are important in your mother’s case. Firstly she is having left sided weakness which may be due to stroke. Secondly she is on a nasogastric feeding pipe and thirdly she is asleep for long hours. Considering all these points, it is better to have the gastric feeding tube.

In this a small tube is inserted through a small incision in the abdomen into the stomach and is used for long-term enteral nutrition. I can understand your apprehension but you must note that prolonged nasogastric feeding cannot be done and some other technique has to be resorted to avoid any malnutrition or further weakness due to non inatek or oral feed.

You can get it done through percutaneous endoscopic gastrostomy also in which the patient is sedated and an endoscope is passed through the mouth and esophagus into the stomach. The position of the endoscope can be visualized on the outside of the patient's abdomen. A small needle is passed through the abdomen which is grasped by the endoscope and pulled up through the esophagus.

Feeding through this route is suitable for long-term use, where there is difficulty with swallowing because of neurologic or anatomic disorders (stroke, esophageal atresia) and to avoid the risk of aspiration pneumonia.

Stroke patients may need such kind of feeding as chances of recovery are less.
Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.










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Follow-up: Is it good to feed through a hole in the stomach for a patient admitted due to weakness in left half of body ? 3 hours later
Thank you Dr. But can you tell me more about feeding pipe if there will be side effects such as infection and whether the operation is very risky and how soon is expected to recover. Will it be required for family member close follow up and feeding. Thanks
 
 
Answered by Dr. Jasvinder Singh 8 hours later
Hello,

Thanks for writing back.

I can understand your concern but the procedure of percutaneous endoscopic gastrostomy takes about 20-30 minutes and is done under local anesthesia. The patient usually can go home the same day or the next morning. Since your mother is admitted, she should be shifted the same day to the ward/ room.

A family member will be required for feeding and for keeping an eye on the complications which may develop like infection of the puncture site (as in any kind of surgery,) dislodgement of the tube with leakage of the liquid diet that is fed through the tube into the abdomen, and clogging of the tube. Sometimes, a gastrocolic fistula may develop which may be suspected if diarrhea appears a short time after feeding. In this case, the feed goes direct from stomach to colon.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Above answer was peer-reviewed by
 
Follow-up: Is it good to feed through a hole in the stomach for a patient admitted due to weakness in left half of body ? 9 hours later
Thank you Dr. I have final question. Stroke, the kind of disease my mum is connected, does stroke cause a patient to sleep most of the time? Thanks
 
 
Answered by Dr. Jasvinder Singh 11 hours later
Hello,

Thanks for writing back.

Stroke can be one of the reasons of excessive somnolence as it may effect the reticular activating system of the brain.

The reticular activating system is responsible for keeping us awake.


Hope this answers your query. Take care and regards.
Above answer was peer-reviewed by
 
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