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The G-tube

As disturbing as they can sometimes be, sensational news stories have a way of educating us in piecemeal fashion. In the aftermath of the Terry Schiavo case, for example, we are now all more aware of the importance of living wills. We are also more aware of something called a feeding tube.

A feeding tube is precisely what it sounds like: a tube that provides nourishment to a person unable to feed him or herself. When someone is unconscious or otherwise incapacitated, a feeding tube is necessary to keep the patient alive.

There are several different kinds of feeding tubes. One, the nasogastric tube, is inserted through a nostril and down through the esophagus into the stomach. It's very uncomfortable, and therefore only good for short term use.

For patients requiring long-term feeding, like Terry Schiavo, doctors most commonly use a gastric feeding tube, or g-tube for short. To insert a g-tube doctors first pass a scope down through the esophagus and into the stomach. A tiny camera on the end of the scope allows doctors to see the inside of the stomach and determine the best place to insert the tube. By using the lighted end of the scope to press the stomach wall up against the skin, a surgeon can make a precise incision and insert the tube directly into the stomach. An inflated balloon at the end of the tube keeps it from slipping out.

G-tubes are an essential, life-saving device; without them, long-term comatose patients could not survive. Family decisions concerning how long such patients should be kept alive, as we now know, are a much thornier problem.

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