A feeding tube is a medical device that delivers nutrition, fluids, and medication directly into the digestive system when a person cannot adequately eat or swallow by mouth. Also known as enteral feeding or tube feeding, these flexible plastic tubes come in various sizes and types, each designed for specific medical needs and durations of use. Their placement can be temporary or long-term.
Temporary Feeding Tube Locations
Temporary feeding tubes are used for short-term nutritional support, typically less than four to six weeks. They are generally placed without surgery, often at the patient’s bedside or in a hospital. These tubes are relatively non-invasive and can be removed or replaced as needed.
The nasogastric (NG) tube is a common temporary feeding tube. It is a thin, flexible tube inserted through one nostril, down the esophagus, and into the stomach. NG tubes are used for short-term feeding, medication administration, and sometimes to decompress the stomach by removing excess air or fluid. An orogastric (OG) tube follows a similar path but is placed through the mouth. OG tubes are often preferred for infants or when nasal insertion is not feasible.
For individuals who cannot tolerate stomach feeding due to impaired emptying or severe reflux, nasojejunal (NJ) or orojejunal (OJ) tubes may be used. An NJ tube is inserted through the nose, guided through the stomach, and advanced into the jejunum, the middle part of the small intestine. An OJ tube follows a similar path but enters through the mouth. These tubes allow continuous, slow feeding directly into the small intestine, bypassing the stomach.
Permanent Feeding Tube Locations
Permanent feeding tubes are designed for long-term use, typically when nutritional support is anticipated for more than four to six weeks. These tubes generally require a surgical or endoscopic procedure for placement, creating a direct opening into the stomach or small intestine through the abdominal wall. This approach provides a more stable solution for extended feeding needs.
A gastrostomy tube, commonly known as a G-tube or Percutaneous Endoscopic Gastrostomy (PEG) tube, is placed directly into the stomach through a small abdominal incision. The PEG procedure uses an endoscope to guide the tube from the mouth, through the esophagus and stomach, then pulled through the abdominal wall. G-tubes are widely used for long-term enteral nutrition when the stomach can tolerate feedings.
A jejunostomy tube (J-tube or PEJ tube) is inserted directly into the jejunum, the middle part of the small intestine, through an abdominal incision. This tube is chosen when stomach feeding is not possible or safe, such as with severe gastric motility issues, chronic vomiting, or a high aspiration risk. J-tubes often require continuous feeding due to the jejunum’s smaller capacity compared to the stomach.
A gastrojejunostomy (GJ) tube is a combination device providing access to both the stomach and the jejunum. Inserted through the abdominal wall like a G-tube, it has two separate ports: one to the stomach and another extending into the jejunum. GJ tubes are useful for individuals needing to drain or vent the stomach while receiving continuous nutrition directly into the small intestine, offering flexibility in managing complex gastrointestinal conditions.
Factors Influencing Tube Placement Selection
The selection of a feeding tube location involves considering various medical and patient-specific factors. One primary consideration is the anticipated duration of nutritional support. Temporary tubes, like nasogastric or orogastric tubes, are suitable for short-term needs, generally less than four to six weeks. If tube feeding is expected to be long-term, typically exceeding this period, a more permanent option such as a gastrostomy or jejunostomy tube is usually preferred.
The patient’s underlying medical condition influences the tube choice. For example, individuals with impaired gastric emptying, severe reflux, or a high aspiration risk may require a jejunostomy tube placed directly into the small intestine. This bypasses the stomach, reducing gastric feeding complications. If the stomach functions adequately, a gastrostomy tube is a suitable option.
The digestive tract’s integrity and function also play a role. Conditions like a narrowed esophagus, stomach outlet obstruction, or certain gastrointestinal disorders can dictate bypassing specific digestive sections. A patient’s overall health status, including surgical ability and complication risk, contributes to the decision for tube placement.