[Dysphagia] Oroesophageal tube feeding

[eripley at yahoo.com (Irene Campbell-Taylor)]

Much like the reluctance to use hypodermoclysis in the US, I find a similar avoidance of oroesophageal tube feeding.  I have demonstrated how easy it is many times, as those who have seen me will attest but so far it is being used only in other parts of the world - most recently Indonesia. Here are a couple of recent references:
   Acta Neurologica Scandinavica
Volume 113 Page 36  - January 2006
            Intermittent oro-esophageal tube feeding in acute stroke patients ? a pilot study
      M. Nakajima1, K. Kimura1, Y. Inatomi2, Y. Terasaki1, K. Nagano1, T. Yonehara2, M. Uchino3, K. Minematsu1

  Campbell-Taylor et al. (6) first introduced 'IOE tube feeding' for adult dysphagic patients including stroke patients. Recently, Kisa et al. reported on the usefulness of this method in chronic stroke patients (7). To the best of our knowledge, we are the first to apply the IOE feeding method to acute stroke patients.
  One of the advantages of IOE feeding is the short time that IOE feeding takes to feed patients. Esophageal peristalsis usually occurs when the food supplement is poured into the esophagus, which is similar to drinking orally. This makes it possible for the supplement to be injected at a rate as fast as 50 ml/min by the IOE feeding method. There may be, however, some concern with the IOE feeding method in acute stroke patients with respect to reflux of supplement into the pharynx due to an esophageal hiatal hernia or decreased esophageal peristalsis. It has been reported that esophageal peristalsis may demonstrate dysmotility in the early phase following a stroke, in particular in a brainstem infarction (8) such as a lateral medullary infarction (9). Therefore, esophagography before the introduction of IOE is advisable
  Kisa T, Igo M, Inagawa T, Fukada M, Saito J, Setoyama M. Intermittent oral catheterization (IOC) for dysphagic stroke patients. J Rehabil Med 1997;34: 113?20.
  Full text at:
  http://www.blackwell-synergy.com/doi/full/10.1111/j.1600-0404.2005.00534.x
   


Dr I Campbell-Taylor
Clinical Neuroscientist
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