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When a person is ill or has a throat problem that prevents normal eating and swallowing, he or she must be fed by other means. If the person is very weak, it is likely that fluid containing glucose will be introduced directly into the bloodstream, bypassing the need for digestion and providing an immediate and continuing source of energy. If, however, the person is strong enough to digest food but has trouble swallowing, food is introduced directly into the stomach through a tube called the bolus tube.
The bolus tube is normally used when a person is able to have meals on a somewhat normal schedule, but cannot chew or swallow. This can be caused by swelling in the throat, some type of damage to the throat, poor swallowing ability or other eating problems. The tube is used to introduce food in the form of a special formula into the stomach, providing more nutrition than can be obtained by intravenous feedings alone.
To use the bolus tube, the person must be in at least a semi-sitting position. A syringe is attached to it and some of the stomach contents, normally just stomach fluids, are pulled up into it to verify that the last meal was adequately digested. The fluids are returned to the stomach and the syringe is rinsed and filled with formula. The formula is pushed through the bolus tube by the pressure of the plunger on the syringe. When the syringe is nearly empty the tube should be clamped shut to prevent air from entering the stomach while the syringe is refilled with formula.
The process continues until the entire amount of formula that was prescribed has been pushed through the bolus tube and into the stomach. It needs to be done slowly so as not to cause digestive upset, and when the entire amount has been given the person needs to remain upright to the extent possible for about an hour. This helps to prevent reflux, the food traveling up the esophagus toward the mouth.
The use of a bolus tube is not uncommon, nor is it particularly difficult. Many adults who use one for nutrition are able to feed themselves. The main concerns are cleanliness of hands and equipment, and watching for problems such as signs of infection, a tube that has been pulled out or the inability to get food into the stomach through the bolus tube. Often a bolus tube will be removed once a person has recovered from the problem that made the tube necessary in the first place.
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