Gastrojejunostomy Tubes
What is a Gastrojejunostomy tube?
A gastrojejunostomy tube, or GJ tube is a type of feeding tube used to administer nutrition, liquids, and medications and can also be used for venting, to let gas out of the stomach. A gastrojejunostomy tube allows for administration of feeding directly into the jejunum (part of the small intestine), for children who cannot tolerate feedings into the stomach. A GJ tube has two access ports, a gastric port that leads to the stomach and a jejunal port that leads to the small intestine. A gastrojejunostomy feeding tube allows for continuous feeding into the small intestine as well as simultaneous venting or decompression of the stomach.
How is a gastrojejunostomy tube placed?
Gastrojejunostomy tubes can be placed surgically by a Pediatric Surgeon or if an existing gastrostomy tract is present, they are often placed endoscopically by a pediatric gastroenterologist or through image guided placement by an interventional radiologist. Routine exchanges of the gastrojejunostomy tube are usually performed as an outpatient procedure and typically do not require a hospital stay.
If an operation is performed for initial placement of a GJ tube, the surgery takes place in the operating room under general anesthesia. An opening is created through the abdominal wall into the stomach and a GJ tube is secured through the tract extending into the small intestine.
How long will my child stay in the hospital?
Following surgery, your child will remain in the hospital for a few days, or longer depending on the needs of your child. The surgical team will determine when it is safe to start using the tube for feeding and medications, generally later that same day or the following day. Your child will be closely monitored, pain medication will be administered as needed, and feedings will be slowly advanced to a custom regimen for your child. Your child will be seen by a dietitian who is specialized in your child’s nutritional needs. Depending on your child’s primary condition, other specialists including a gastroenterologist may be involved in your child’s care.
What is expected after surgery?
Most children recover from surgery in about a week. It is important to learn how to properly care for the GJ tube. Potential complications associated with GJ tubes include infection, leaking, skin irritation, intussusception of the small intestine, migration of the jejunal portion out of position, and accidental dislodgement.
Hands on education for caregivers will be provided during the hospital stay to teach you how to care for the GJ Tube and administer feedings and medications.
Important Tips
- Clean daily with warm water and mild soap. Keep the skin around the GJ tube clean and dry.
- Feeds should be delivered via the J port in a continuous manner, as the small bowel cannot accomondate for larger bolus feeds.
- The G port may be used for venting during feeds.
- The GJ tube should be changed by Interventional Radiology every 6-12 months. It is not to be changed out at home.
- Medications may be administered via the J port only if specified as not all medications can be metabolized by the small bowel.
- If the GJ tube becomes dislodged, notify your provider immediately. Place your spare Gtube of the same size in the stoma to keep the tract from closing until a new GJ tube can be safely replaced. Refer to Gtube page for replacement instructions.
- Do not rotate the GJ tube as this may cause the jejunal portion to migrate out of the small intestine.
Click here for more information about GJ tubes:
https://www.appliedmedical.net/resources/edu-guides/G-JET_C-4418-C_English.pdf