enteral

Enteral refers to nutrition or medications delivered through the gastrointestinal tract. In medical practice, enteral nutrition includes both oral intake and tube feeding that reaches the stomach or small intestine. It is generally preferred over parenteral (intravenous) nutrition when the gut is functional, because it supports gut integrity, reduces infection risk, and is typically more cost-effective.

Routes and methods vary. Oral feeding can be supplemented with specialized formulas if needed. Tubes provide access for longer-term feeding and include nasogastric or orogastric tubes, nasojejunal tubes for post-pyloric delivery, and longer-term access such as percutaneous endoscopic gastrostomy (PEG) or jejunostomy (PEJ). Feeds may be delivered as continuous infusions via a pump, intermittent boluses, or cyclic feeds. Formulas range from polymeric (standard whole-nutrition formulas) to elemental or semi-elemental preparations for impaired digestion, with specialized formulas for conditions such as renal or pulmonary disease and diabetes.

Indications and considerations. Enteral nutrition is indicated when a patient cannot meet nutritional needs by mouth but has a functioning gastrointestinal tract, such as in certain neurological disorders, critical illness, or after major surgery. It is unsuitable when the GI tract is nonfunctional or when there is an obstruction, severe ileus, or other conditions that preclude safe feeding. Decisions about route, rate, and formula depend on patient tolerance, risk of aspiration, and specific medical conditions.

Safety and monitoring. Potential complications include aspiration pneumonia, tube misplacement or occlusion, nasal/oral mucosal injury, diarrhea or constipation, electrolyte or glucose disturbances, and, in malnourished patients, refeeding syndrome. Monitoring focuses on tube position, feeding tolerance, weight and fluid balance, and laboratory markers to adjust the regimen as needed.