Enteral Feeding (Gastrointestinal) Interventions

A gastrostomy tube (or “G-tube”) is a flexible catheter that is inserted through the abdominal wall directly into the stomach. This device allows nutrition to be delivered directly into the stomach, bypassing the mouth and esophagus. Insertion of a gastrostomy tube may be performed surgically or with minimally invasive methods using imaging-guidance such as real time x-rays (fluoroscopy) and ultrasound. A narrow tube is inserted through the nose into the stomach. Air is injected into the tube to allow distension of the stomach which can be seen on x-rays. Numbing medication is injected into the skin around the upper abdomen before insertion of a fine needle through the skin into the stomach using x-ray guidance. The positioning of the needle is confirmed by injecting contrast. The small hole is then dilated to fit the size of the gastrostomy tube before the tube is placed over a wire into the stomach and secured into place. The tube may be used for feeding starting about four hours post procedure.

Sedation: Local anesthesia (lidocaine) and moderate sedation (fentanyl and midazolam).

Procedure time: 30 minutes.

A gastrojejunostomy tube (or “GJ-tube”) is a flexible catheter that is inserted through the abdominal wall directly into the stomach before continuing into the small intestine (jejunum). This device allows nutrition to be delivered directly to the stomach or the small intestine, bypassing the mouth, esophagus, and stomach. Feeding through this tube directly into the intestine may be best for patients who are prone to gastroesophageal reflux and aspiration. Tube insertion is performed with minimally invasive methods using X-ray guidance. A narrow tube is inserted down the nose into the stomach. Air is passed through this tube to allow distension and visualization of the stomach on x-ray. Numbing medication is injected into the skin around the upper abdomen before insertion of a fine needle through the skin into the stomach using x-ray guidance. The positioning of the needle is confirmed by injecting contrast. Then, a long tube will be placed over a wire into the stomach and down the small intestine (jejunum) before being secured into place. The tube may be used for feeding on the same day as the procedure. 

Sedation: Local anesthesia (lidocaine) or moderate sedation (fentanyl and midazolam).

Procedure time: 30-60 minutes.

A jejunostomy tube (or “J-tube”) is a flexible catheter inserted through the abdominal wall directly into the small intestine (jejunum). This device allows nutrition to be delivered directly to the small intestine, bypassing the esophagus and stomach. Feeding this way may be best for patients prone to gastroesophageal reflux and aspiration (inhalation of gastric contents). Insertion of a jejunostomy tube is performed with minimally invasive methods using imaging guidance (e.g., x-ray, ultrasound). During the procedure, numbing medication is injected into the skin before insertion of a fine needle into the small intestine using x-ray and/or ultrasound guidance. The positioning of the needle is confirmed by injecting contrast. Then a tube is placed over a wire into the small intestine (jejunum) before being secured into place. The tube may be used for feeding the same day as the procedure. 

Sedation: Local anesthesia (lidocaine) or moderate sedation (fentanyl and midazolam).

Procedure time: 30 minutes.