**2. Indications for enteral nutrition**

Optimal hydration and nutrition is required to meet the body's daily nutritional requirements. Patients with dysphagia may be unable to attain these minimum nutritional requirements with oral intake and require enteral nutrition [2-9]. These patients include those who are unable to swallow due to neurological damage or degeneration [4, 10-15], or those who have structural abnormalities that make oral nutrition impossible, as in the case of patients with advanced stage head and neck cancer or oesophageal cancer [16-18].

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The most common indicator for long term enteral nutrition is a cerebral vascular accident (CVA) [3, 5, 10-12, 19-26]. Dysphagia with resulting malnutrition and/or dehydration is common in patients who have had a CVA, explaining the high need for enteral nutrition within this population [10, 13, 27-28]. Patients with other neurological deficits such as traumatic head injury or neuro-degenerative diseases, may also require short or long term enteral nutrition as a safe method of hydration and nutrition [7, 29-33].

Certain medical conditions are more likely to predispose patients to require enteral nutrition because of concomitant dysphagia and increased nutritional needs. Patients with head and neck cancer may develop dysphagia after radiation treatment as a result of tissue damage to the swallow mechanism [18] with a resultant need for prophylactic enteral nutrition [17]. Those patients who continue on oral intake may require enteral nutrition as a supplement to ensure sufficient intake of the daily nutritional requirements while receiving radiotherapy [18]. In cases of trauma to the body or after surgery, enteral nutrition is also recommended to aid sufficient caloric intake to minimise loss of body fat and to support recovery [15, 29, 31-32, 34-35].
