Nausea connected with feeding tube

[Stranger N Strange Land]

Hi all.

I'm not sure if this is the right forum but I'm going to dive in anyway.

My MIL has had a feeding tube for several months now and has been doing well, gaining weight, increased energy. Recently however she's been struggling with feeling really nauseated. She was given a script for Zofran, which helps some but has also been slowing the speed of her feeding. (It can take up to 2 hours for her to finish a feeding and she has 4 a day, so she feels she's always hooked up to a gravity/kangaroo bag. This also means she's dependent on others because she struggles with removing the feeding tube extension and closing the button on her own.) Needless to say, slowing the feeding seems to help with nausea.

The illness has progressed to a point where she can no longer safely swallow foods unless they go through a food processor. She is still mobile around the house but is losing strength overall. She recently reported that she's struggling with breathing at night and has begun having headaches for the first time. She's worried that her diaphragm is beginning to go.

My worried thought is that the stomach is a muscle too. Does it begin to atrophy as well as the other muscles and if so, could this be causing some of her nausea? Has anyone had similar issues with this. She's had the kind of food changed out a few time and seems to be doing ok on this current formula (Jevity 1.5).

Thank you.

 

[Graybeard]

It takes no more than 15 minutes to take 8 oz of Boost+ through my peg, followed by 250cc of water. Repeat five more times a day. I am able to do it all myself; no nausea yet.

Sounds like she desperately needs a bipap. My diaphragm is dead.

 

[dalvin]

I find that if the formula is at room temperature I get nauseated. Try heating the formula just a bit, you don't want it hot so be careful. With it taking that long to feed, you might try putting smaller amounts in at a time. Heat a little then just before the bag is empty add a little more until she's gotten her full amount.
For the breathing issue, highly recommend a bipap and keep her upper body elevated. When you lay flat, your organs are redistributed which makes it harder for the diaphragm to work. The headaches sound like a classic symptom of co2 poisoning which will be alleviated by the bipap and elevating her upper body. I had those same headaches every morning until I started the bipap

 

[Graybeard]

I sleep well when prone with the bipap. Seldom have a hint of a headache. My diaphragm is dead.

 

[Diane H]

Try running all her feedings over night at a constant slow rate to get most of her nutrition in. Then she can snack on tasty stuff from the food processor or ice cream, pudding, etc. during the day. BiPAP will relieve the headaches as well as decrease the nausea. Digestion takes oxygen and nausea is common when there isn't enough!

 

[affected]

Everyone has given lots of good advice to help with the nausea. Another idea is to have overnight feeding so she is free from the peg during the day.

I would get her breathing checked as it does sound like CO2 build up.

Lastly, the stomach is not made of motor muscles, so it does not atrophy due to ALS. However, if the PALS goes for a long period of not eating the digestive system will begin to slow down.

 

[Stranger N Strange Land]

Thank you all. This was very helpful.