A Feeding Tube Can Be Used for Palliative Decompression Too

Abstract

Journal of Palliative MedicineVol. 14, No. 4 Letters to the EditorOpen AccessA Feeding Tube Can Be Used for Palliative Decompression TooAh San PangAh San PangSearch for more papers by this authorPublished Online:6 Apr 2011https://doi.org/10.1089/jpm.2010.0498AboutSectionsPDF/EPUB ToolsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail Dear Editor:Palliative medicine has gently and firmly established itself in my country, Singapore. “A Cup of Hot Chocolate” published in the June 2010 issue of the Journal of Palliative Medicine is evidence of how far it has come.1 When the article appeared, the community with which author Sean Lim was affiliated announced the event widely. I celebrated it too because palliative medicine has an important role to play. I do not work in this specialty; my perspective is necessarily that of an outsider and may not be applicable outside of Singapore.While much has been achieved, much more needs to be done. By way of example, I have used the reported case. It must be emphasized that I am not criticizing the institutions involved; sometimes it is simply just patient's choice.A nasogastric tube, or its variation, is not comfortable at all. Thus, 23% of physical restraints used in the nursing homes in Singapore are for the sole purpose of preventing the tube from being pulled out.2 In my opinion, it is ironic when an uncomfortable option is used for palliation.The percutaneous endoscopic gastrostomy is a better option. Although it is easily inserted using local anesthesia and sedation, tube dislodgement and difficult tube exchange can cause serious complications like buried bumper syndrome, hemorrhage, and peritonitis. Hence, it is understandable why some colleagues do not like it and advise their patients to stick with the low-risk but low-comfort nasoenteral option.With the availability of a new gastrostomy tube that is devoid of complications associated with tube dislodgement and tube exchange, it may be time for a re-think.3 In this way, more patients may be spared the discomfort and indignity during the last phase of their journey.References1 Lim RCSA cup of hot chocolateJ Palliat Med201013775.1. Lim RCS: A cup of hot chocolate. J Palliat Med 2010;13:775. Link, Google Scholar2 Mamun KLim JUse of physical restraints in nursing homes: Current practice in SingaporeAnn Acad Med Singapore200534158162.2. Mamun K, Lim J: Use of physical restraints in nursing homes: Current practice in Singapore. Ann Acad Med Singapore 2005;34:158–162. Medline, Google Scholar3 Pang ASA new feeding tube which is secure and easy to changeSingapore Med J200950740741.3. Pang AS: A new feeding tube which is secure and easy to change. Singapore Med J 2009;50:740–741. Medline, Google ScholarFiguresReferencesRelatedDetails Volume 14Issue 4Apr 2011 InformationCopyright 2011, Mary Ann Liebert, Inc.To cite this article:Ah San Pang.A Feeding Tube Can Be Used for Palliative Decompression Too.Journal of Palliative Medicine.Apr 2011.388-388.http://doi.org/10.1089/jpm.2010.0498creative commons licensePublished in Volume: 14 Issue 4: April 6, 2011PDF download