But even with skilled care there can be side effects. Implantation through the abdominal wall can cause surgical complications and skin infection. Feeding tubes can traumatize and erode the lining of the nasal passage, esophagus, stomach, or intestine. Most patients fed by tube have brain disease and are unable to report that they feel full or unwell, so abdominal bloating, cramps, or diarrhea may occur. Regurgitation is common, and the feed may be inhaled into the lungs.
Confused patients can also be anxious over the tube's presence and try to pull it out.
Intravenous lines can be uncomfortable, especially if fluid leaks into the skin or the skin becomes inflamed or infected. Intravenous fluids must be given with extra care to frail patients in order to avoid fluid overload and serious breathing difficulties. Although potentially valuable and life saving in many situations, artificial nutrition and hydration do not provide comfort care for dying patients. Experience and available scientific evidence have shown that death without artificial nutrition or hydration is natural and pain free. When patients experience severe symptoms, such as pain or nausea, these are due to the disease itself, not the avoidance of food and water.