A nasojejunal tube is a medical device designed to deliver nourishment directly into the small intestine. It provides a way to ensure adequate nutrition when an individual cannot safely or sufficiently consume food by mouth. This temporary solution bypasses parts of the digestive system to facilitate nutrient absorption.
What a Nasojejunal Tube Is
A nasojejunal (NJ) tube is a soft, narrow tube inserted through the nose, extending into the jejunum, a section of the small intestine. The “naso” refers to the nose as the entry point, while “jejunal” specifies its destination. This design allows for the delivery of liquid formula and medications past the stomach.
The tube is made of a flexible material, such as silicone or plastic, for comfortable passage and to minimize irritation. It ensures nutrients and fluids are absorbed efficiently in the small bowel without relying on stomach function. This method is useful when the stomach cannot tolerate or process food.
When a Nasojejunal Tube is Needed
A nasojejunal tube is considered when an individual cannot meet nutritional needs orally or when stomach feeding is unsuitable. Reasons include the inability to swallow safely, which risks aspiration, or conditions like severe reflux or persistent vomiting that prevent the stomach from retaining food.
Delayed gastric emptying, where the stomach empties food too slowly, is another indication. Bypassing the stomach allows for continuous, slow delivery of nutrients directly into the small intestine, which is often better tolerated. This approach ensures the body receives adequate nutrition even when normal stomach function is impaired.
How a Nasojejunal Tube is Placed
Nasojejunal tube placement is a medical procedure performed by trained healthcare professionals, often in a hospital or radiology department. The process begins with inserting the tube through one nostril. It is then guided down the throat, through the esophagus, and into the stomach.
To ensure the tube progresses into the jejunum, individuals may be asked to swallow or sip water, which helps facilitate passage. Imaging techniques, such as X-rays or fluoroscopy, are used during or after insertion to confirm the tube’s location in the small intestine. Once positioned, the tube is secured to the face with tape to prevent dislodgment.
Living with a Nasojejunal Tube
Living with a nasojejunal tube involves daily care routines to ensure proper function and minimize complications. Regular flushing with water prevents blockages from formula or medications. This should occur before and after each feed and medication administration, and every four to six hours even when not actively feeding.
Feeding schedules are continuous, delivered slowly over several hours using a pump, as the jejunum has limited storage capacity. Medications, if not liquid, need to be crushed and diluted before administration, with flushing between each. Maintaining hygiene around the tube insertion site on the nose and cheek is important, involving gentle cleaning with soap and water and regular tape changes to prevent skin irritation and infection.
Monitoring the tube’s position is a daily task; a mark on the tube at the nostril should be checked regularly to detect movement. If the tube appears dislodged, or if issues like persistent nausea, vomiting, or difficulty flushing occur, medical advice should be sought immediately. Careful management helps ensure the tube remains functional and provides nutritional support.