Question

A patient has espophageal cancer and must have a feeding tube inserted. The nurse tells the patient that the tube will be inserted surgically into the duodenum. The wife asks why it will not be inserted into the stomach. What should the nurse say?

Answer 1

Answer:

Human digestive system comprises of a number of important organs arranged one after the other. Their arrangement is as follows;

Oral cavity-pharynx-esophagus (food pipe)-stomach-small intestine-large intestine-anus.

These different organs perform a number of functions and also the movement of the food within the different parts of the alimentary canal is strictly monitored with the help of valves and sphincters. Likewise, one such sphincter is present between esophagus and the stomach and hence is called as gastro-esophageal sphincter which is partially functional in nature that is at times regurgitation of partially digested food might occur from the stomach to the outwards direction through esophagus; process called as ecesis/vomiting.

So, when a person has an esophageal cancer, and feeding pipe needs to be placed surgically, it has to be directly placed in the duodenum of the small intestine and not the stomach. Insertion in the stomach might add on to compilations as chances of vomiting can persist throughout.

Also, duodenum of the small intestine is the site wherein the process of digestion gets completed due to the opening of the hepato-pancreatic duct which carries juices from pancreas and liver thus facilitating the completion of the digestion. Also, since the digestion is getting completed in the duodenum, it will be the site for maximum absorption to occur for which finger like projections called villi are present and they increase the available surface area for enhancing the absorption.

When a patient is suffering from an esophageal cancer, for sure he patient has to be supplied with a liquid diet throughout the life time. This is because the feeding tube will not have a lumen to permit the push of bolus (masticated form of food). In case of liquid diets, stomach will not have much role to be played as the food form can directly be digested and absorbed within the duodenum of small intestine.

And thus keeping these points in mind, the feeding tube will be placed directly into the duodenum and not stomach.