Tracheoesophageal Fistula

WHAT YOU SHOULD KNOW:

  • Tracheoesophageal (tra-ke-o-e-sof-ah-JE-al) fistula (FIS-tu-lah), or TEF, is an abnormal connection between the trachea and the esophagus. The trachea (windpipe) is the passageway through which the air we breathe travels to the lungs. The esophagus (food pipe) is a tube that carries food from the mouth to the stomach. TEF may be congenital (something that happened before birth) or it may occur anytime during life. In TEF, air passes from the airway into the stomach or food passes from the esophagus into the lungs. This may lead to breathing or swallowing problems, which can be serious or life-threatening.

  • Signs and symptoms of TEF are an enlarged abdomen (stomach), drooling, or having lots of mucus (secretions) in the mouth. You may also have trouble breathing and swallowing, such as shortness of breath or coughing when swallowing. TEF may be diagnosed by having a chest x-ray, barium swallow, bronchoscopy, computerized tomography (CT) scan, or endoscopy. Treatment will depend on the underlying cause of TEF and how bad it is. You may need medicine, oxygen, a stent, or surgery to treat your TEF. With treatment, such as medicine and surgery, TEF may be cured and your quality of life may be improved.

INSTRUCTIONS:

Take your medicine as directed.

Call your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

Diet:

  • You may not be able to eat food through your mouth for a period of time. A caregiver, called a dietitian, may talk to you about your feeding and nutrition. A swallowing therapist may also work with you if you have trouble swallowing. This person has special training to help people learn safer ways to swallow. The swallowing therapist will also help you learn which foods and liquids are safe to eat and drink.

  • You may be fed with high-calorie feedings or given total parenteral nutrition (TPN). TPN is used when you have problems with eating food. It provides your body with nutrition, such as protein, sugar, vitamins, minerals, and sometimes fat (lipids). TPN is usually put into your body through a large IV catheter or a gastrostomy tube. A gastrostomy tube goes directly from the outside of your body into your stomach.

Respiratory care:

  • Breathing treatments: You may need breathing treatments to help open your airways so you can breathe easier. A machine is used to change liquid medicine into a mist. You will breathe the mist into your lungs through tubing and a mouthpiece. Inhaled mist medicines act quickly on your airways and lungs to relieve your symptoms.

  • Humidifier: Using a humidifier moistens the air in your home. The moist air makes it easier to cough up your sputum (mucus from the lungs). Wash the humidifier each day with soap and warm water to keep it free of germs.

  • Oxygen: You may need extra oxygen to help you breathe easier. It may be given through a plastic mask over your mouth and nose. It may be given through a nasal cannula, or prongs, instead of a mask. A nasal cannula is a pair of short, thin tubes that rest just inside your nose. Tell your caregiver if your nose gets dry or if you get redness or sores on your skin. Never smoke or let anyone else smoke in the same room while your oxygen is on. Doing so may cause a fire.

  • Smoking: Do not let anyone smoke around you. Smoke can make your coughing or breathing worse. If you smoke, you should quit. You will not only help yourself, but also those around you. Ask your caregiver for more information about how to stop smoking if you are having trouble quitting.

Rest:

Rest when you feel it is needed. Slowly start to do more each day. Return to your daily activities as directed.

CONTACT A CAREGIVER IF:

  • You have a fever.

  • You have chills or a cough.

  • You have any questions or concerns about your condition, treatment, or care.

SEEK CARE IMMEDIATELY IF:

  • You are choking and cannot breathe.

  • You are coughing or vomiting (throwing up) blood.

  • You are having problems with swallowing or drinking.

  • Your skin, lips, or fingernails are pale or bluish in color.

  • Your voice has changed and become hoarse.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Tracheoesophageal Fistula (Aftercare Instructions)

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