Enteral administration
Enteral administration refers to the process of delivering food or medication directly into the gastrointestinal (GI) system, allowing for absorption and processing by the body. This method encompasses several approaches, including oral, gastric, and rectal administration. The most common form is oral administration, where patients swallow food or medications, facilitating digestion much like healthy individuals. When oral intake is impossible or insufficient, enteral feeding may be performed using a tube inserted through the nose, mouth, or directly into the abdomen. This tube feeding ensures patients receive necessary nutrition or medication, particularly in cases where traditional swallowing is not viable.
Additional methods within enteral administration include sublingual and buccal routes, which allow for quick absorption through the mucous membranes in the mouth. In certain situations, when enteral method options are inadequate, rectal administration of medications via suppositories may be utilized. This approach can be especially useful for patients who are unable to swallow or retain oral medications due to various medical conditions. Overall, enteral administration is crucial in healthcare for delivering essential nutrients and medications to patients who require alternative feeding or treatment methods.
On this Page
Subject Terms
Enteral administration
Enteral administration is a medical term for the process of giving a patient food or medication directly into the gastrointestinal system. The gastrointestinal system then absorbs nutrients or drugs and processes them for the body’s use. Enteral administration is one of several means for administering food or medication. The others, including parenteral or intravenous administration, bypass the gastrointestinal tract.
![rssphealth-20190201-17-174088.jpg](https://imageserver.ebscohost.com/img/embimages/ers/sp/embedded/rssphealth-20190201-17-174088.jpg?ephost1=dGJyMNHX8kSepq84xNvgOLCmsE2epq5Srqa4SK6WxWXS "Gastrointestinal system. BruceBlaus. When using this image in external sources it can be cited as:Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436. [CC BY 3.0 (https://creativec")
There are several means of enteral administration, including oral, gastric, and rectal administration. Each refers to the method by which the food or medication enters the body. The usual method would be oral administration, in which a patient takes food or medication by mouth and swallows it for digestion, just as healthy people do. When a patient is unable to consume food or medication orally or unable to consume enough to remain healthy, a tube may be inserted through the nose, mouth, or directly into the abdomen so food and medication can be administered. In some cases, rectal administration is used.
Background
The gastrointestinal system includes the mouth, the esophagus, the stomach, the small and large intestines, and the anus. When people eat food or swallow a medication, it enters the mouth and travels down the esophagus into the stomach. The act of chewing combined with fluids such as saliva and stomach acid break down the food or medication into smaller components and nutrients, which are then absorbed by the body and sent to where they are needed. This is accomplished with the help of other parts of the digestive system, including the gallbladder, liver, and pancreas, and regulated by the action of nerves and hormones. Once the food is broken down, it passes into the intestines where liquid is extracted and the waste products are processed to be excreted as stool.
There are some instances when oral ingestion of food or medication is not possible or desirable. Some medications will not work or will not work as well if they come in contact with the digestive fluids in the gastrointestinal tract. Some work better or faster when they are administered intravenously, or directly into the blood stream. Some are injected into a specific area of the body, such as a joint or into the spine. Others are administered subcutaneously, or under the skin, or intramuscularly into a muscle.
When the enteral administration of food is not appropriate, parenteral nutrition may be used. This involves placing a tube into a vein and administering a solution containing nutrients directly into the bloodstream. Some cases where parenteral nutrition might be used include when the gastrointestinal tract is not functioning properly or needs to be rested to improve the patient’s condition, or when it is important for the patient to receive specific amounts of nutrients that might be altered by digestion.
Overview
Swallowing food or drugs by mouth for processing through the gastrointestinal tract is the usual method for people to receive nutrition and many medications. This is a form of enteral administration of nutrition or medication. In most cases, this is the easiest and best way for people to consume nutrients or many medications.
Other methods of enterally administering medications that use the mouth but not the rest of the gastrointestinal tract are sublingual or buccal administration. Sublingual administration involves placing the medication, usually a dissolvable tablet or film or a liquid that is dropped or sprayed under the tongue, which is also known as the lingua. In buccal administration, the drug is placed between the cheeks and gums. From here the medication is directly absorbed by the body through the mucosa, or membranes, under the tongue or in the cheek. This is used in cases where the drug needs to get into the body quickly, when the patient is unable to swallow, or when the drug is adversely affected by the digestive process.
Enteral administration can also be accomplished by means of a tube that allows food or medication to be placed directly in the stomach. The tube may be inserted through the patient’s nose, mouth, or into an opening placed through the skin. Patients who need to be fed this way temporarily will generally have a tube inserted through the nose or mouth, while those who have conditions that will require tube feeding for a long period of time will have a gastrostomy tube inserted through the skin directly into the stomach. This is also referred to as tube feeding.
Food or medication can then be administered through a syringe or by means of a special pump that moves the liquefied food or medication through the tube to the stomach. The food can be a special mixture or, in some cases, regular food that is processed into a liquid to allow it to pass through the tube. The medications can be those that come in liquid form or medical professionals may crush a tablet or take the contents of a capsule and mix them with water before administering. This form of enteral nutrition is used when the person is not taking enough food by mouth, is unable to swallow, or has some other problem consuming food or medication by swallowing.
Medical professionals take special care when administering food or medication through tubes. The tubes are marked during insertion so that the person administering something through it can tell if it has been pulled out or pushed in farther than it should be. This ensures that the liquids added to the tube go into the stomach and not elsewhere in the body. Care will also be taken to clear the tube and make sure that it remains clean and unblocked. When tubes are inserted directly into the stomach, the insertion point is also monitored for signs of infection or irritation.
In some cases, none of these methods of enteral administration can be used for a medication and rectal administration will be used. This involves using a suppository, or small capsule of medication that will melt at body temperature. The suppository is inserted through the patient’s anus to the rectum, where it dissolves and delivers the medication to be absorbed through the membranes of the intestines into the blood stream. Rectal administration may be used when a patient is unconscious, is having seizures, is vomiting too much to retain the medication, or when the medication might upset the stomach and cause vomiting. This method is also used in some instances when patients cannot or will not swallow, and for drugs intended to work in the intestines, such as laxatives.
Bibliography
Bareuther, Carol M. “Nutrition Options—Enteral and Parenteral Feedings.” Today’s Geriatric Medicine, Sept. 2008, http://www.todaysgeriatricmedicine.com/archive/071708pf.shtml. Accessed 29 March 2019.
Boullata, Joseph I. et al. “ASPEN Safe Practices for Enteral Nutrition Therapy.” American Society for Parental and Enteral Nutrition, 10 Nov. 2016, https://onlinelibrary.wiley.com/doi/full/10.1177/0148607116673053. Accessed 29 March 2019.
“Enteral Feeding and Medication Administration.” Royal Children’s Hospital Melbourne, Dec. 2017, https://www.rch.org.au/rchcpg/hospital‗clinical‗guideline‗index/Enteral‗feeding‗and‗medication‗administration/. Accessed 29 March 2019.
“Enteral and Parenteral Nutrition.” American College of Gastroenterology, http://patients.gi.org/topics/enteral-and-parenteral-nutrition/. Accessed 29 March 2019.
“How to Use Rectal Suppositories.” Healthline, 30 Sept. 2016, https://www.healthline.com/health/general-use/how-to-use-rectal-suppositories#troubleshooting. Accessed 29 March 2019.
Kinman, Tricia. “Sublingual and Buccal Administration.” Healthline, 5 Dec. 2016, https://www.healthline.com/health/sublingual-and-buccal-medication-administration. Accessed 29 March 2019.
Williams, Nancy Toedter. “Medication Administration Through Enteral Feeding Tubes.” American Journal of Health System Pharmacy, https://login.medscape.com/login/sso/getlogin?urlCache=aHR0cHM6Ly93d3cubWVkc2NhcGUuY29tL3ZpZXdhcnRpY2xlLzU4NTM5Nw==&ac=401. Accessed 29 March 2019.
“Your Digestive System and How It Works.” National Institute of Diabetes and Digestive and Kidney Diseases, Dec. 2017, https://www.niddk.nih.gov/health-information/digestive-diseases/digestive-system-how-it-works. Accessed 29 March 2019.