Cystic fibrosis is a genetic disorder that causes persistent infection of the lungs and progressively limits the victim’s ability to breathe. A gene called Cystic fibrosis transmembrane conductance regulator (CFTR) protein is rendered dysfunctional through mutation. The inability of the gene to function correctly implies that its duty of helping move chloride to the surface of the cell is greatly impaired. If the cell surface lacks chloride, it cannot attract water, making the mucus in different organs sticky and thick.
The mucus in the lungs blocks the airways in addition to trapping such germs as bacteria. This leads to inflammation, respiratory failures, infection, and other forms of complications. Cystic fibrosis victims are, therefore, required to strictly minimize their contact with germs. The presence of mucus in the pancreas inhibits the release of enzymes that are crucial for the absorption of food and nutrients leading to poor growth and malnutrition (Spilsbury, 2019). The mucus can also clog the bile duct in the liver and cause liver disease.
Cystic fibrosis is managed in accordance with its severity and type. Thus, treatment plans should be tailored to the unique circumstances of the victim. However, there are universal therapies that apply to all persons with Cystic fibrosis. These include airway clearance, inhaled medicine, pancreatic enzyme supplement, and the use of CFTR modulators. Clearing airways helps in loosening and eradicating the thick mucus that clogs the lungs.
Inhaled medicines help in thinning the mucus or opening the airways. Meanwhile, supplements of pancreatic enzyme capsules facilitate the absorption of essential nutrients. They are taken together with meals and snacks by the victim. The underlying CFTR protein defect is managed by the use of CFTR modulators. Since various mutations cause different protein defects, the available medications are only effective to individuals with CF-specific mutations.
Enteral Feedings
Enteral feeding is the process of using the gastrointestinal (GI) tract to take food. The gastrointestinal tract entails the mouth, esophagus, stomach, and intestines. However, Enteral feeding is not only confined to nutrition passed through the mouth. Even food passed through a tube into the stomach or the small intestines is referred to as Enteral feeding. In a medical setting, tube feeding is the most predominant form of Enteral feeding. An Enteral feeding individual must be having some injury or a condition that prevents him from using the mouth to eat a regular diet. This is despite the fact that their GI tract still functions appropriately.
Enteral feeding is primarily considered in situations of a stroke, cancer, critical illnesses, inability to eat in infants, movement or neurological disorders, and GI dysfunctions. Incidentally, a person’s ability to swallow can be impaired by stroke. On its part, cancer can cause nausea, vomiting, and fatigue, which makes it problematic to eat. Individuals who suffer critical injuries and illnesses often experience reduced energy that affects their eating abilities, hence, the use of tubes. There are six main Enteral feeding tubes types, each with its procedure for use. They include nasogastric tube (NGT), orogastric tube, nasoenteric tube, oroenteric tube, gastronomy tube, and jejunostomy tube.
The procedure of placing the nasogastric tube is painless and straightforward. A nurse only needs to measure the tube’s length before lubricating it and placing it in the mouth or nose of the patient. She will then advance it down till it reaches the stomach. A soft tape is used to secure the tube to the patient’s skin. A syringe will then be used to pull out some gastric juice from the tube to check for acidity and confirm if the tube has indeed reached the stomach. Placement can also be confirmed through the use of an X-ray (Dix, 2018). The use of an enteral feeding tube can, however, be accompanied by some complications. Some common complications include refeeding syndrome, irritation of the skin at the site of insertion, tube dislodgement, aspiration, vomiting and nausea, and tube infection.
Dysphagia
Dysphagia is a medical term that is used to describe swallowing difficulties. Usually, it is a problem of the esophagus or throat, which is the muscular tube responsible for the movement of food and liquids to the stomach from the back of the mouth. It is more prone among older adults, people with the nervous system or brain conditions, and babies. For food and liquids to move down the stomach without any hitch, the esophagus and throat muscles must contract and squeeze.
If this does not happen, there are possibly two problems attributed to it. First, due to the failure of the nerves and muscles responsible for the movement of food down the esophagus and throat. This can be occasioned by a stroke or spinal or brain injury or a problem of the immune system that results in the weakness and swelling of the throat. It can also be attributed to the esophageal spasm, which refers to the sudden squeeze of the esophagus that occasionally blocks food from reaching the stomach.
Second, due to the blockage of the esophagus or throat as a result of Gastroesophageal reflux disease (GERD), esophagitis, diverticula, and esophageal tumors. Dysphagia is further associated with some complications such as malnutrition, dehydration, and weight loss, aspiration pneumonia, and choking. Aspiration pneumonia results from the introduction of bacteria from the foods into the lungs. Patients should be taught the importance of thoroughly chewing food before swallowing and eating slowly (Desuter, 2019). Besides, they should be encouraged to go for screenings regularly. If detected early, the risks of GERD graduating into esophageal stricture are lowered.
References
Desuter, G. (Ed.). (2019). Oropharyngeal dysphagia: Videoendoscopy-guided work-up and management. Springer.
Dix, M. (2018). Enteral feeding: How it works and when it’s used. Healthline. Web.
Spilsbury, R. (2019). Cystic fibrosis. Rosen Central.