Endoscopic approaches to enteral nutritional support

There are several forms of endoscopic enteral access for nutritional support. ENTs are appropriate for short-term feeding, most often for seriously ill, hospitalized patients. PEGs are appropriate for longer-term feeding in persons with an intact gut who cannot consume adequate nutrition. PEGJs and DPEGs are best suited for management of severe regurgitation and aspiration of gastric feeds, malignant gastric outlet obstruction refractory to endoscopic stenting, concomitant gastric decompression, and jejunal feeding in pancreatitis. Advances in techniques and equipment have made these procedures efficient and technically successful with acceptable outcomes and morbidity. Endoscopic enteral access procedures are important for optimal patient management and should be in the repertoire of a consultant endoscopist. © 2002 Elsevier Science Ltd. All rights reserved.