A j-tube (or PEJ) is a feeding tube which is inserted into the patient's jejunum (small intestine). It can be placed in one of three ways: endoscopically, laparotomy, or laparoscopically.
During the procedure:
A PEJ tube is placed endoscopically and is much less invasive than a j-tube placement. It can be performed by a gastrointerologist. This procedure is conducted by placing a scope down the patient's esophagus (as is done during an endoscopy), through the stomach, and into the first portion of the jejunum while the patient is sedated. Once the scope reaches a good spot in the jejunum, the physician knows where to make the incision based on a light on the end of the scope that can be seen through the skin. Once the incision is made and tube inserted, a hard bolus is attached to the tube on the inside of the jejunum in order to hold it in place.
A j-tube can be placed either laparoscopically or through an open procedure. A j-tube differs from a PEJ primarily due to the way it is placed. In addition, j-tubes typically have a balloon on the end that is inflated by a valve on the outside. The downside of the balloon is that it is not uncommon for the intestines to pop the balloon and the j-tube will fall out. It is important to get to the ER to have a new one placed before the hole closes back up.
After the procedure:
After a PEJ, the patient may go straight home or remain in the hospital overnight.
Usually after a surgical placement the patient will remain in the hospital at least for a few days as the nutrition is started very slowly. Once the patient has reached a satisfactory tolerance level of feedings, he/she will be discharged under the care of a home health agency. Tube feedings can be infused overnight or over a 24 hour period as needed. Portable backpacks and equipment are available.
Complications include pain, bowel obstruction, not tolerating feedings, skin and internal infections. However, the complications are usually less serious than those associated with IV nutrition (TPN). It is a better option for long term nutritional support.
What is a g-tube?
A g-tube (or PEG) is a feeding tube which is inserted into the patient's stomach. Although it is typically not an ideal solution for feeding a person with gastroparesis due to the delayed gastric emptying, it does provide some patients with a way to better control the nausea and vomiting by providing a "burp" valve which allows the patient to drain out the stomach as needed top prevent severe nausea and vomoting. Typically, a g-tube is placed at the same time and in the same manner as a j-tube (or PEJ).