History, application, procedures, and effects of intermittent oral catheterization (IOC)

Kisa T, Sakai Y, Tadenuma T, Maniwa S. History, application, procedures, and effects of intermittent oral catheterization (IOC). Jpn J Compr Rehabil Sci 2015; 6: 91-104. Intermittent catheterization (IC), developed in Japan, involves inserting a catheter or feeding tube from the patient's mouth or nose for the purpose of dysphagia rehabilitation or feeding. Among the various IC methods, intermittent oral catheterization (IOC) involves inserting a catheter from the mouth to the lower part of the esophagus or stomach. Because the gag reflex is decreased in encephalopathy patients with dysphagia, oral insertion of a catheter is generally easy, and can be applied to patients who are capable of complaining of incorrect insertion or showing an objective symptom (regardless of dementia, etc.). IOC is effective for dysphagia patients, including those with cancer of the oral cavity or head and neck, neuromuscular disease, and for stroke patients in the acute convalescent, and chronic stages. Stroke patients receiving IOC showed higher oral intakes of regular meals than patients fed by a gastrostomy tube or continuous nasogastric catheterization (CNG). IOC care requires less monitoring and restraining time than CNG and results in better stomach discharge function than a gastrostomy. Gastrostomy should be applied to patients for whom IOC is not applicable or those in the convalescent stage who previously received IOC but who require alternative nutrition over a long period because only small amounts can be ingested via IOC.