title: Self-insertion of a nasogastric tube for home enteral nutrition: a pilot study.
abstract: BACKGROUND
  Enteral tube feeding can be a source of discomfort and reluctance from patients. We evaluated for the first time the tolerability of self-insertion of a nasogastric (NG) tube for home enteral nutrition (EN).
  
  
  METHODS
  All patients requiring enteral tube feeding for chronic diseases were enrolled in a therapeutic patient education (TPE) program at Nancy University Hospital.
  
  
  RESULTS
  In our department, between November 2008 and August 2012, 66 patients received EN with an NG tube. Twenty-nine of 66 had self-insertion of the NG tube (median age, 44 years), 17 had an anatomical contraindication, and 20 were excluded because of cognitive disability or language barrier or refusal. Twenty-eight of 29 patients completed the TPE program. One patient died of pancreatic cancer in palliative care during the study. Median follow-up was 20 months (interquartile range [IQR], 4-31). Median gain weight was 3.1 kg (IQR, 1.8-6.0) (P = .0002). Median duration of self-insertion of the NG tube was 3 months (IQR, 2-5), and it was well tolerated by all 29 patients. Two patients described minor adverse events: abdominal pain and nausea for 1 patient and epistaxis leading to temporary discontinuation of EN for another patient. A group of 10 consecutive patients previously had a long-term NG tube for EN. If they had the choice between a self-inserted NG tube and a long-term NG tube, all 10 patients reported they would prefer to start again with the self-inserted NG tube.
  
  
  CONCLUSIONS
  This pilot study suggests that self-insertion of an NG tube may be efficacious and well tolerated in patients receiving EN for chronic conditions.
authors.affiliation: Department of Nutrition, Nancy University Hospital, Vandoeuvre-les-Nancy, France INSERM U954, Medical Faculty and CHU of Nancy, Vandoeuvre-les-Nancy, France d.quilliot@chu-nancy.fr.
authors.forename: Didier
authors.initials: D
authors.lastname: Quilliot
authors.affiliation: INSERM U954, Medical Faculty and CHU of Nancy, Vandoeuvre-les-Nancy, France Department of Gastroenterology, Nancy University Hospital, Vandoeuvre-les-Nancy, France.
authors.forename: Camille
authors.initials: C
authors.lastname: Zallot
authors.affiliation: Department of Nutrition, Nancy University Hospital, Vandoeuvre-les-Nancy, France.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Malgras
authors.affiliation: INSERM U954, Medical Faculty and CHU of Nancy, Vandoeuvre-les-Nancy, France Department of Hepatobiliary, Digestive and Endocrine Surgery, Nancy University Hospital, Vandoeuvre-les-Nancy, France.
authors.forename: Adeline
authors.initials: A
authors.lastname: Germain
authors.affiliation: Department of Hepatobiliary, Digestive and Endocrine Surgery, Nancy University Hospital, Vandoeuvre-les-Nancy, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Bresler
authors.affiliation: INSERM U954, Medical Faculty and CHU of Nancy, Vandoeuvre-les-Nancy, France Department of Hepatobiliary, Digestive and Endocrine Surgery, Nancy University Hospital, Vandoeuvre-les-Nancy, France.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ayav
authors.affiliation: Department of Gastroenterology, Nancy University Hospital, Vandoeuvre-les-Nancy, France.
authors.forename: Marc-André
authors.initials: MA
authors.lastname: Bigard
authors.affiliation: INSERM U954, Medical Faculty and CHU of Nancy, Vandoeuvre-les-Nancy, France Department of Gastroenterology, Nancy University Hospital, Vandoeuvre-les-Nancy, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Peyrin-Biroulet
authors.affiliation: Department of Nutrition, Nancy University Hospital, Vandoeuvre-les-Nancy, France INSERM U954, Medical Faculty and CHU of Nancy, Vandoeuvre-les-Nancy, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Ziegler
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D003680:Deglutition Disorders / Q000209:etiology; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects / Q000379:methods*; D008297:Male; D009325:Nausea / Q000209:etiology; D017060:Patient Satisfaction; D010865:Pilot Projects; D012648:Self Care / Q000009:adverse effects
keywords: enteral tube feeding; home enteral nutrition; self-insertion of nasogastric tube; self-management; therapeutic patient education