ReviewNutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition2026
Gastrostomy tube care, replacement, and removal: Expanding the registered dietitian nutritionist scope of practice to provide more comprehensive enteral nutrition support and ongoing patient-centered care.
Review in Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Authors and funding
4 authors.
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Abstract
The prevalence of community-dwelling individuals dependent on home enteral nutrition (HEN), commonly delivered via gastrostomy tube (G-tube), continues to rise. Fragmented healthcare approaches often lead to limited follow-up support, inadequate education, and insufficient routine G-tube maintenance. This can lead to preventable complications, such as infection, tube dysfunction, dislodgement, and avoidable emergency department visits. The Registered Dietitian Nutritionist (RDN), already central to HEN management, is uniquely positioned to provide comprehensive G-tube assessment and care. International models demonstrate that RDNs trained in advanced practice roles to deliver G-tube care, including balloon G-tube (BGT) replacement, can improve access, enhance patient satisfaction, and reduce healthcare utilization and costs. Expanding the RDN scope of practice to include G-tube management represents an opportunity to improve continuity of care for HEN consumers while addressing gaps in healthcare access and reducing health care system burden. This narrative review describes current practices for routine BGT care and exchanges and explores the benefits of RDN-led G-tube management. Three U.S.-based institutional approaches to credentialing RDNs in G-tube care and replacement are described. In addition, key implementation components, such as stakeholder engagement, policy development, competency-based training, and interdisciplinary collaboration, are highlighted. Standardized training pathways, broader support, and further research on outcomes are needed to support wider implementation of this advanced practice role.
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