My brother Georg after stroke 3 months ago still has nasogastric tube for feeding. Neurologist talks about PEG tube inserted right into stomach. Is there anyone with similar experience after stroke- permanent or temporary.
Hello
Thank you for reaching out on EnableMe. I am sure that there are others within the community that will have had experience themselves, or through a loved one in regard to PEG feeding.
Naso gastric tubes are generally placed when a patient has initial dysphagia (swallowing difficulties) from a stroke. The placement for a Nasogastric tube is usually short-term or temporary, due to risk of mucosal injury and infection.
For more long-term options, the PEG (percutaneous endoscopic gastrostomy) tube is traditionally used. A PEG tube is a feeding tube placed into your stomach. It allows liquid nutrition (food), fluids and medicine to go straight into your stomach.
You can remain on PEG feeding long term. If you no longer need PEG feeding the tube can be removed. The Doctors would talk with you and your brother about the process for this. A speech pathologist and dietitian would also be involved in the decision regarding a PEG and it might also be helpful to get some more information from them around this recommendation. Before discharge, the nursing staff would also provide some education to you and your brother around how to manage the PEG tube and site.
Dietitians are normally involved in all stages of the nutrition process. A dietitian will assess your brother to see what his nutritional needs are and if he is currently getting adequate nutrition and a speech pathologist will assess his swallowing ability and safety. They will usually collaborate and discuss with the team their recommendation of the most suitable feeding choice for him. Usually, your brother will see a dietician for some time, even once he has been discharged.
According to Australian and New Zealand Living Clinical Guidelines for Stroke Management
“After a stroke, a number of stroke-specific factors can result in decline in nutrition and hydration status. The most notable cause of poor oral intake (aside from altered consciousness) is oropharyngeal dysphagia. Additional factors could include fatigue, hemiplegia, depression, visual spatial neglect, reduced mobility and ability to self-feed, taste changes, reduced appetite and poor oral health.”
“Being malnourished is associated with poor outcomes after a stroke. Moreover, malnutrition could persist after a stroke if not effectively managed. Key aspects of nutritional management include malnutrition screening, assessment by an Accredited Practising Dietitian, and nutrition supplementation. “
It is most important to always engage with your brothers current medical and allied health team (Dietitian and Speech pathologist) to discuss any questions regarding Nutritional feeding and risks associated. The doctors will also have these conversations with the both of you.
If anyone in the stroke community is able to share their experiences to this family, that would be greatly appreciated.
It might also be helpful for you to reach out to our nursing and allied health professionals here on StrokeLine, this way we can talk with you in more detail. You can a call us on Ph 1800 7887 653 or email us on strokeline@strokefoundation.org.au. We are open Monday to Friday 9am to 5pm AEST.
Best Wishes
Alicia ( StrokeLine)
Hi,
I had both the nasal tube and the peg later, The peg was in my stomach for around 9 months from memory. I spent some 9 weeks in hospital so had the peg at home for a long while and was taught how to use it, suppling supplements while I learnt to eat normally again.
I couldn't swallow or talk at first, so six years post stoke I can eat normally still have speech issues but doing ok all considered I'm still alive!
Nasal 1st then had a peg put in as the docs were not sure about Long term. After a Barium swallow test, I was cleared to eat everything. The peg was removed without it being used. Prevention is better than the cure, I guess.
My brother has now removed nasal feeding tube and is able to swallow even medication tablets cut to half and drink water from cup. What I like to know HOW MUCH FOOD WERE YOU ABLE TO EAT AT ONCE AFTER TUBE REMOVAL because Georg eats very little thou he was a good eater before stroke but he is still in hospital and we talking about hospital food which I'm absolutely sure he hates as he was used to home cooking from raw ingredients. Worried Sister asking.
Yes quite normal , breath trouble , swallowing trouble , can't smell , talking troubles and hearing lost and face numbness , Also more felling in leg and arm , Breathing is caused but your diaphragm being affect by the stroke , it just depends on what type of stroke , and no they can't fix it .At least I have had it for 6 years .