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BC Home Enteral Nutrition
(HEN) Program

The BC Home Enteral Nutrition (HEN) Program provides support to patients in British Columbia and the Yukon who have specialized nutrition requirements due to gastrointestinal tract (“gut”) problems.

For people who require enteral nutrition at home, the BC HEN Program can help support pediatric and adult patients with gastrointestinal diseases who medically require semi-elemental or elemental formulas. Formula tolerance alone does not make these types of formulas necessary.

There are many illnesses which can prevent people from being adequately nourished with regular food. The most common reasons for HEN in our pediatric patients include treatment of Crohn's disease and unusual causes of intestinal malabsorption. The most common reason for HEN in our adults is malabsorption due to short bowel syndrome in patients with Crohn’s disease.

Please note that the BC HEN Program has very specific application criteria. Refer to the Pediatric and Adult Application forms for more information.

What is Enteral Nutrition?

Enteral nutrition (EN) is a type of nutritional therapy that is usually provided in a hospital, rehabilitation facility or residential care facility. EN is commonly called “tube feeding.” Tube feeding is when special liquid food, also known as formula, is given through a tube into the stomach or small bowel. The formula can be pushed through the tube with an infusion pump, by gravity or by syringe.

People being tube fed have a functioning gut, but may not be able to eat enough or at all because of an illness. Some people may be tube fed overnight to supplement what they eat orally during the daytime. Sometimes, patients may be asked by their health care team to not eat regular foods for a specified period of time. These patients are advised to take formula only for “bowel rest.”

EN can also be used to describe special liquid food taken orally. Some people are able to drink their formula instead of having it by tube.

There are many different types of formula. The usual components of an EN formula are protein, carbohydrates, fat, vitamins, minerals and fluid. The following table briefly describes common formula categories:

Formula Type	Formula Description	General Indications
Polymeric	Standard formula made with intact protein	Full gut function Unable to eat or drink enough by mouth due to an illness or swallowing problem (“dysphagia”)
Semi-elemental	Specialized formula made with partially broken down (“hydrolyzed”) protein	Moderate gut function Maldigestion / malabsorption Sensitivity to intact proteins Unable to tolerate polymeric formula
Elemental	Specialized formula made with fully broken down (“hydrolyzed”) protein	Limited gut function Maldigestion / malabsorption Severe food allergies Unable to tolerate semi-elemental formula

What is Home Enteral Nutrition (HEN)?

For many pediatric patients and most adult patients, EN is usually initiated in a hospital setting when a patient is unwell and unable to eat or drink adequately. While many patients recover from their illness and are discharged from hospital without requiring further treatment, some patients still require EN after discharge. Home enteral nutrition (HEN) allows patients who are well enough to receive their nutrition at home.

Who might need HEN?

HEN is a good option for people, of any age, who will be on EN for a long time and are able to perform any required tube feeding procedures themselves or have a family member do so. The length of time patients require HEN varies from a few months to life.

Visit the Oley Foundation for more information about HEN.

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