Which feeding option is most commonly used for long-term feeding in patients with dysphagia?

• A. Gastrostomy/PEG.
• B. Nasogastric tube.
• C. Oral supplementation only.
• D. Intravenous nutrition.

Answer: (A)

Long-term enteral feeding in dysphagia is best supported by a gastrostomy/PEG because it provides durable, comfortable access to the stomach for ongoing nutrition. A nasogastric tube is useful for short-term feeding but becomes uncomfortable and inconvenient over weeks to months, with higher risks of tube displacement, nasal irritation, and accidental misplacement—making it impractical for extended use. Feeding goals in dysphagia aim to meet caloric and fluid needs safely, while minimizing discomfort and aspiration risk; a PEG tube stays in place, often allows home use, and supports gradual diet advancement and consistent nutrition.

If the gut cannot be used or functional for enteral nutrition, intravenous (parenteral) nutrition is considered, but this is generally reserved for when the GI tract is not usable or when enteral feeding is contraindicated, due to higher infection risk and metabolic complications. Relying on oral supplementation alone does not address significant swallowing impairment and may fail to meet the patient’s nutritional requirements.