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Difference Between Enteral and Parenteral Nutrition

Both enteral (medical term for intestinal) and parenteral (occurring outside the intestine) feeding are delivery methods of artificial food for patients who have digesting or eating problems. The special liquid formulations generally contain proteins, sugars, vitamins, minerals, and fats. These may be given to people of all ages and are often used for a short time (American Society for Parenteral and Enteral Nutrition, 2022).  Specifically, enteral feeding is the transport of nutrients via the gastrointestinal tract. On the other hand, parenteral feeding bypasses the gut by delivering the food into the bloodstream (Lakna, 2019). 

What is Enteral Nutrition? 

Enteral nutrition (EN) is the transport of nutrients beyond the esophagus through feeding tubes; it also includes the oral intake of dietary foods for particular medical purposes (Kolacek, 2013). This method is used for patients who have significant appetite loss, swallowing difficulties, or undergone a kind of surgery which interferes with eating. It may be given to people of all ages and is often used for a short time. It involves a special liquid food mixture that contains vitamins, minerals, protein, carbohydrates, fats (American Society for Parenteral and Enteral Nutrition, 2022). 

The following are the enteral access devices used (Kirby & Parisian, 2021): 

  • Nasogastric Tube (NGT) 

– through the nose into the stomach

– short-term use 

  • Orogastric Tube

– through the mouth into the stomach

– short-term use 

  • Nasoenteric Tube 

– through the nose into the intestines

– short term use 

  • Oroenteric Tube

– through the mouth into the intestines 

– short-term use 

  • Gastrostomy Tube

– through the abdomen, directly into the stomach 

  • Jejunostomy Tube 

– through the abdomen, directly into the jejunum 

The possible complications of enteral feeding include food going into the lungs, dangerous electrolyte imbalances, tube or insertion site infection or irritation, nausea and vomiting from too fast or too large feeds, tube dislodgement, loose bowel movement, and tube blockage. Patients with stomachs or intestines that are not working properly should not have enteral feeding (Dix, 2018).  

What is Parenteral Nutrition? 

Parenteral Nutrition (PN) is the intravenous administration of nutrition for patients who cannot absorb enough nutrition via mouth or tube feeding formula. It bypasses the usual digestion in the gastrointestinal tract by directly giving sterile liquid formula into the bloodstream.  This kind of nutrition may be given to infants, children, and adults; it is usually used for a short time and is discontinued or lessened when the patient begins to eat by mouth or begins to switch to tube feeding (American Society for Parenteral and Enteral Nutrition, 2022). 

The following are the two main types of parenteral feeding (Birt, 2021): 

  • Total Parenteral Nutrition (TPN)

– central catheter inserted into a major vein carrying blood from the head and chest to the heart (superior vena cava)

– long-term use 

  • Peripheral Parenteral Nutrition (PPN) 

– administered through a traditional, external IV 

– short-term use (i.e., recovering from an operation)

The most common side effects of parenteral nutrition include skin changes, mouth sores, and poor night vision. The most common risk is catheter infection; other risks include liver disease, blood clots, and bone disease (Stephens, 2017). 

Difference between Enteral and Parental Nutrition 

Definition

Enteral nutrition (EN) is the transport of nutrients beyond the esophagus through feeding tubes; it also includes the oral intake of dietary foods for particular medical purposes (Kolacek, 2013). Parenteral Nutrition (PN) is the intravenous administration of nutrition for patients who cannot absorb enough nutrition via mouth or tube feeding formula. It bypasses the usual digestion in the gastrointestinal tract by directly giving sterile liquid formula into the bloodstream (American Society for Parenteral and Enteral Nutrition, 2022). 

Types 

The enteral access devices used include nasogastric tube, orogastric tube, nasoenteric tube, oroenteric tube, gastrostomy tube, and jejunostomy tube (Kirby & Parisian, 2021). As for parenteral feeding, the two main types are total parenteral nutrition and peripheral parenteral nutrition (Birt, 2021). 

Side Effects/ Complications

 The possible complications of enteral feeding include food going into the lungs, dangerous electrolyte imbalances, tube or insertion site infection or irritation, nausea and vomiting from too fast or too large feeds, tube dislodgement, loose bowel movement, and tube blockage (Dix, 2018).  In comparison, the most common side effects of parenteral nutrition include skin changes, mouth sores, and poor night vision. The most common risk is catheter infection; other risks include liver disease, blood clots, and bone disease (Stephens, 2017). 

Enteral Nutrition vs Parental Nutrition

Frequently Asked Questions: 

Why is enteral nutrition better than parenteral?

The advantages of enteral feeding include being cheaper, able to maintain the mucosal barrier of the GI tract, and a simpler method as compared to parenteral feeding. Moreover, parenteral feeding may have more serious complications such as hypercholesterolemia, hyperglycemia, and catheter-related sepsis (Lakna, 2019). 

What is the difference between enteral and parenteral route of drug administration?

Enteral nutrition utilizes a feeding tube into the stomach or intestines. The tube may be inserted through the nose, mouth, or abdomen. On the other hand, parenteral nutrition is administered intravenously through a catheter (Birt, 2021). 

What is an example of parenteral nutrition?

One example of parenteral nutrition is Fat Emulsion (Fish Oil Based) with the brand name Omegaven (Drugs.com, 2021). 

Summary 

  • Both enteral and parenteral feeding are delivery methods of artificial food for patients who have digesting or eating problems.
  • Enteral nutrition (EN) is the transport of nutrients beyond the esophagus through feeding tubes; it also includes the oral intake of dietary foods for particular medical purposes.
  • Parenteral Nutrition (PN) bypasses the usual digestion in the gastrointestinal tract by directly giving sterile liquid formula into the bloodstream.


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References :


[0]American Society for Parenteral and Enteral Nutrition (2022). What is enteral nutrition. https://www.nutritioncare.org/About_Clinical_Nutrition/What_is_Enteral_Nutrition/

[1]Dix, M. (2018). Enteral feeding: How it works and when it’s used. Healthline. https://www.healthline.com/health/enteral-feeding

[2]Drugs.com (2021). Fat emulsion. https://www.drugs.com/cdi/fat-emulsion-fish-oil-based.html

[3]Kolacek, S. (2013). Enteral nutrition. Word Review Nutrition Diet. https://pubmed.ncbi.nlm.nih.gov/24029791/

[4]Kirby. D. & Fawley, R. (2021). Enteral and parenteral nutrition. American College of Gastroenterology. https://pop.gi.org/topics/enteral-and-parenteral-nutrition/

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