Using tube feeding (via nose or stomach) in people with cystic fibrosis

Conway S, Morton A, Wolfe S

Published Online:

May 12, 2010

Cystic fibrosis (CF) is an inherited disease which causes damage to the lungs and pancreas (an organ needed for the body to absorb food). People with CF need more calories than average to manage problems with breathing caused by lung damage. Supplements are often given via a tube through the nose or stomach (enteral tube feeding). These are to improve weight gain, nutritional status, lung function and quality of life. However, tube feeding is expensive and may lead to low self-esteem and poor body image. We have identified 16 trials in our searches, but none of these are randomised controlled trials showing the effects of enteral tube feeding. Hence no trials are included in the review. More research is needed to compare tube feeding with oral supplements and with normal diet. Trials should look at when tube feeding should be started for the best results.

Abstract (click to read)

Background:

Enteral tube feeding is routinely used in many cystic fibrosis centres when weight for height percentage is less than 85%, when there has been weight loss for longer than a two-month period or when there has been no weight gain for two to three months (under five years old) or for six months (over five years old).

Objectives:

To examine the evidence that in people with cystic fibrosis supplemental enteral tube feeding improves nutritional status, respiratory function, and quality of life without significant adverse effects.

Search strategy:

We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register which comprises references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings. We also contacted the companies that market enteral feeds and reviewed their databases.

Date of the most recent search of the Group's Cystic Fibrosis Trials Register: 30 November 2009.

Selection criteria:

All randomised controlled trials comparing supplemental enteral tube feeding for one month or longer with no specific intervention in people with cystic fibrosis.

Data collection and analysis:

Sixteen trials were identified by the searches; however, none were eligible for inclusion in this review.

Main results:

There are no trials included in this review.

Authors' conclusions:

Supplemental enteral tube feeding is widely used throughout the world to improve nutritional status in people with cystic fibrosis. The methods mostly used, nasogastric or gastrostomy feeding, are invasive, expensive, and may have a negative effect on self-esteem and body image. Reported use of enteral tube feeding suggests that it results in nutritional and respiratory improvement and it is disappointing that their efficacy has not been fully assessed by randomised controlled trials. With the more frequent recommendations to use enteral tube feeding as an early rather than a late intervention, this systematic review identifies the need for a multicentre, randomised controlled trial assessing both efficacy and possible adverse effects of enteral tube feeding in cystic fibrosis.

This record should be cited as:

Conway S, Morton A, Wolfe S. Enteral tube feeding for cystic fibrosis. Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No.: CD001198. DOI: 10.1002/14651858.CD001198.pub2

Assessed as up to date:

April 13, 2010

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Primary Review Group:

Cystic Fibrosis and Genetic Disorders Group

Health topics:

Gastroenterology > Cystic fibrosis > Nutrition

Genetic disorders > Cystic fibrosis > Nutrition

Lungs & airways > Cystic fibrosis > Nutrition

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

Using tube feeding (via nose or stomach) in people with cystic fibrosis

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