FEEDING TUBE PLACEMENTS
Nasojejunal tube placement
A nasojejunal or NJ-tube is done to thread a tube through the stomach straight into the jejunum, which is the middle section of the small intestine, to allow nutrition, fluids and medications to be put directly into the small intestine, bypassing the stomach. With the tube being passed down the nose or mouth into the oesophagus, into the stomach, through the pylorus and into the jejunum (and in some cases the duodenum), nutrition can be absorbed by the body
Why might a nasojejunal tube be needed?
This is often done for people who cannot tolerate feeding into the stomach due to dysfunction of the stomach (like gastroparesis and pervasive refusal syndrome), impaired gastric motility, severe reflux or vomiting. It may also be advised by your gastroenterologist if you are unable to swallow safely, your stomach does not empty fast enough or if your body is unable to absorb calories and nutrition quickly enough.
How is a nasojejunal tube placed?
Prior to the placement of the NJ tube, your gastroenterologist will ensure that your stomach and bowels are empty. Dr Mokhele will instruct you to stop eating any food 8 hours before and that you take a laxative to flush out the colon before your procedure.
This tube may be placed using endoscopic surgical techniques on an outpatient basis. In most cases, the patients are only sedated, but Dr Mokhele may choose general anaesthesia for younger children having a nasal-jejunal tube placed. While the procedure won't be painful, it may be a bit uncomfortable. You will be instructed to sit upright while your gastroenterologist inserts the tube through your nostril. You may be asked to lower your chin to your chest – this will help the tube move along the back of your throat. The tube is then fed into your oesophagus and stomach and through the first part of the small intestine. Next, your gastroenterologist will make use of an x-ray to ensure that the tube is in the right place and move it to the correct position if necessary.
Now that the tube is in place, Dr Mokhele will secure the tube to your nose and cheek with tape. He will also mark the tube so he can monitor if the tube has moved in or out. With the help of your dietician and gastroenterologist, you will be given the necessary feeding formula and pump to get nutrition. Because the jejunum is small, it can only take a small amount of food at a time. Your feeding tube will be attached to a bag of liquid formula which will pump food into the tube at a slow, continuous rate. If you believe that your feeding tube has moved out of place or you begin to gag, cough or gag and breathing becomes difficult, you should seek emergency care.
Gastrocure, Eastern Cape
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