VATICAN CITY – Pope John Paul II (search) is getting nutrition from a tube in his nose, the Vatican said Wednesday, shortly after the frail pontiff appeared at his window in St. Peter's Square and managed only a rasp when he tried to speak.
Vatican spokesman Joaquin Navarro-Valls said the step was taken to "improve the pope's calorie intake" and so he can recover his strength. It was unclear when the tube was inserted but it was not visible when John Paul made his appearance.
The tube is not the only source of nutrition for the pope, a Vatican official said on condition of anonymity.
Asked about reports of a possible hospitalization, the official said there were no plans at this time and any decision would be up to his doctors.
The medical report was the first issued on the pope since March 10 — three days before he was discharged from the hospital for the second time in a month.
The statement appeared indirectly to deny media reports that the 84-year-old pope might be hospitalized again to insert a feeding tube in his stomach because of problems swallowing food.
Feeding tubes are common in patients requiring supplemental nutrition. A "nasogastric tube," which John Paul has, is threaded down the nose and throat into the stomach. Liquid food is then fed through it. While uncomfortable, no sedation or surgery is required.
Dr. Barbara Paris, director of geriatrics at Maimonides Medical Center in New York, said the tube may be just a temporary measure to boost John Paul's nutrition while he continues his recovery. But she said it could also be the first step toward having a more permanent feeding tube inserted directly into his stomach.
That procedure, known as PEG — percutaneous endoscopic gastrostomy (search) — involves making an incision in the abdomen so a tube can be passed directly into the stomach.
The nasogastric tube is less invasive and a simpler solution, Paris said.
Francesco Pierconti, a pathologist at Gemelli Polyclinic (search) in Rome who did not treat John Paul, said feeding tubes like the one used by the pope usually need to stay in place for "two or three days, then they get removed for disinfection."
The statement Wednesday said John Paul spends "many hours" seated in an armchair, celebrates Mass in his private chapel and has work contacts with his aides "following directly the activities of the Holy See and the life of the church."
It said the pope continues "his slow and progressive convalescence" and that public audiences remain suspended.
It also said medical assistance is guaranteed by the Vatican medical staff under the direction of the pope's personal physician, Dr. Renato Buzzonetti, an apparent reference to reports that outside medical help has been called in.
The pope was rushed to Gemelli twice last month with breathing crises. On Feb. 24, he underwent throat surgery to insert a tube in his windpipe and ease his breathing.
Navarro-Valls made the announcement shortly after the pope appeared at his studio window and blessed thousands of faithful in St. Peter's Square. The ailing pontiff raised his hand in blessing and made the sign of the cross as a Vatican official read greetings and prayers.
The pope looked alert during the appearance, his first since Easter Sunday. A microphone that had been readied by papal aides was quickly removed after the pontiff unsuccessfully tried to say a few words.
The appearance drew cheers from thousands of pilgrims gathered in the square beneath the pope's third-floor window, decorated with the pope's crimson banner. Some of the faithful had tears in their eyes.
Kate Strauss, an American tourist in St. Peter's Square with her family, said, "We happened to be here by chance and we just had no idea we'd get a blessing from him and a blessing for the babies."
"He looks very frail but certainly very committed to seeing his people," she said.
The pontiff was unable to preside at Holy Week events because of his ailments. On Easter Sunday, he tried but failed to speak to tens of thousands of people gathered for Mass in the square.
John Paul last spoke to the public on March 13, shortly before being discharged from hospital. In addition to the breathing tube, John Paul suffers from Parkinson's disease, which makes it difficult for him to talk, and knee and hip ailments.