Clinical Nutrition in Gastrointestinal Disease

Alan Buchman, MD, MSPH

Chapter 44: Home Enteral Nutrition (continued)

Lyn Howard, MD, FRCP; Christopher C. Ashley, MD, MPH

Provision of enteral nutrition (EN) through a tube at home has a long history1,2 and goes back to ancient Egypt.3 By the mid-twentieth century patients with severe swallowing disorders were quite often managed at home, fed bolus meals through large-bore rubber nasogastric (NG) or surgical gastrostomy tubes using homemade blenderized diets. But this approach tended to be uncomfortable and unsightly and was frequently refused by many stroke or cancer dysphagic persons, preferring the shorter course of aspiration pneumonia, the so-called “poor man’s friend.” In the latter…