Overview

TPN vs tube feeding are form of nutritional therapy for patients who cannot get enough nutrients from their diet. The major difference between this two form of nutrition is that Total Parenteral Nutrition (TPN) deals with the supply of all daily nutritional requirements in sufficient amount directly into the bloodstream intravenously, while Tube feeding also known as Enteral nutrition is the supply of required nutrients through a tube channeled directly into the stomach or small intestine.

Another distinct characteristics of these forms of nutrition- TPN vs tube feeding is that TPN as one of the types of parenteral nutrition bypasses the entire GI tract and supply nutrients directly into the bloodstream through a large central vein, while tube feeding passes through a functional GI tract. This means that for a successful tube feeding to take place, the patient must have a functional GI tract which starts from the mouth and ends in the anus.

The condition that leads to total parenteral nutrition (TPN) and tube feeding may be similar but the approaches to these conditions are different. Thus, in the course of this article, you will understand where these forms of nutrition are applied and who truly needs them.

What is TPN?

Total parenteral nutrition is one of the two types of parenteral nutrition in which a sterile liquid chemical formula that contains all the daily required nutrients in sufficient amount is directly channeled into the bloodstream through the vein. Because TPN solutions are highly concentrated and thick, the solutions must be channeled through catheters placed in a large central veins in the neck, chest, or groin. Unlike the peripheral parenteral nutrition (PPN) that is passed through a small vein.

In TPN, complete nutrition that contains adequate nutrients is administered to the body through a large vein and it’s a good option for a nutrition disorder that affects a person’s GI tract, therefore it does not rely on gastrointestinal function.

A typical TPN bag contains a mixture of lipids (fat), amino acids (protein), glucose (carbohydrates), electrolytes (minerals), vitamins, and fluids. The nutrient bag is connected to the bloodstream through an intravenous catheter rather than going through the normal digestion processes.

There are nutritional disorders that urgently needs total parenteral nutrition and these conditions makes it difficult for feeding, digestion and absorption of required nutrients in the body. They includes:

• Bowel obstruction
• Crohn’s disease
• An abnormal connection between two organs (fistula)
• Gastrointestinal cancer
• Malnutrition
• Short bowel syndrome
• Intestinal failure
• Gastrectomy.

Side effects of Total Parenteral Nutrition (TPN).

TPN is easier but have some risks and complications associated with it during long term practice such as:

• Dehydration and electrolyte imbalances
• Catheter infections due to bacteria
• Thrombosis (accumulation of blood clots)
• Hyperglycemia (high blood sugars)
• Hypoglycemia (low blood sugars)
• Liver dysfunction
• Bone disease (osteoporosis)

What is tube feeding?

Tube feeding also known as enteral nutrition is a method of supplying special liquid food formula that contains all the daily required nutrients via a tube directly connected to the stomach or small intestine. This form of nutrition therapy is for patients that are malnourished due to inability to feed well to meet their nutritional requirements, thus lacking in essential nutrients needed in the body.

It is a temporary form of nutrition that requires a functional GI tract that will enable quick absorption of key nutrients in the body. Feeding tubes can be passed through the mouth, nose, stomach and small intestine and where a feeding tube is inserted usually depends on how long tube feeding is needed for a patient. Tube feeding involve the following types or processes:

1. Orogastric tube: This is a type of tube feeding through the mouth. Here, the tube follows the same pathway through the throat and esophagus down to the stomach. It is used to supply nutrients to a patient for at least a maximum of 2 weeks before it is either removed or replaced.
2. Nasogastric tube: This is a special tube that carries essential food nutrients to the stomach through the nose. It’s for patients that are unable to tolerate solid foods by mouth. It lasts for at least 4 to 6 weeks.
3. Gastrostomy tube: This is also called a G-tube and its inserted through the stomach to feed the body with the required nutrients. This type of tube feeding can last for a long period of time, a maximum of 12 months or more depending on the injury or surgery that impairs the patient’s ability to receive enough nutrition through eating. It can be replaced with time under the supervision of a dietitian or doctor.
4. Jejunostomy tube: This involves a surgical incision into the jejunum (a part of the small intestine) to allow the passage of a feeding tube from outside the body to facilitate nutrition until the patient is healthy enough to eat by mouth. This type of tube feeding can last for a lifetime or permanent for chronic nutrition disorders.

Tube feeding is a cheaper and less complicated form of nutrition. There are conditions that require tube feeding or enteral nutrition they includes:

• Loss of appetite due to physiological factors
• Coma
• Parkinson disease
• Cancer
• Gastrointestinal complications due to trauma
• Bowel obstructions
• Stroke
• Pneumonia

According to a recent hospital-based database constructed by the Diagnosis Procedure Combination survey data comprising more than 100 acute-care hospitals, it was found that “many older inpatients (aged > 65 years) with pneumonia cannot feed orally after admission and may need nutritional care such as nasogastric tube feeding or total parenteral nutrition”.

Side Effects of Tube feeding.

The risks of tube feeding can be properly managed under the supervision of a Dietitian or Doctor. It is an easier and cheaper method with risks such as:

• Aspiration
• Regurgitation (Swallowed foods moving up to the feeding tube)
• Stomach bloating
• Nausea
• Dry mouth
• Constipation
• Irritation of the skin
• Dehydration
• Diarrhea

Is there need for TPN Vs Tube Feeding?

The entire concept of enteral and parenteral nutrition is to tackle the issues of malnourishment and help in managing chronic health conditions that impairs feeding and digestion processes. If you or your loved ones are unable to eat enough and get essential nutrients and calories throughout the day, there are high chances of loosing weight and being exposed to serious health problems.

TPN vs Tube feeding are feeding methods that can help in supplying the daily nutrients to patients with certain health conditions that deprive them chances of eating right and living healthy. In these feeding methods, nutrients such as glucose, lipids (fats), amino acids, vitamins, minerals, water and even medicine are administered through tube and needles connected to their veins, mouth, stomach, nose and other pathways to enable them receive the energy and hydration they need to survive.

Similarities- TPN and Tube feeding

• TPN and tube feeding are two forms of nutrition therapy for correcting nutrition disorders.
• They are both in liquid state.
• TPN and tube feeding are good methods of providing daily essential nutrients to patients.
• Both TPN and tube feeding are simple methods.

Major Differences- TPN Vs Tube Feeding

The key differences in TPN Vs Tube Feeding lies in their type of nutrition, supply of nutrients, risks, processes, complications, cost, structure and functions.