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A jejunostomy tube is also referred to as a J-tube or a feeding tube. It is inserted through the abdomen in the the jejunum, which is the second section of the small intestine. This surgical procedure can be performed using a laparascopy or through a more traditional surgical approach. Generally, a jejunostomy tube is used only in cases where the patient is unable to eat on his or her own or has other severe problems ingesting or absorbing food.
Conditions that often require a jejunostomy tube include the inability to digest food or a failure of the stomach to empty properly, making it necessary to bypass the stomach altogether to provide adequate nutrition. Pancreatic disease also can require use of a jejunostomy tube to ensure adequate nutrition. This type of tube can be used for a short time or the long time, depending on the patient's condition and individual needs. In addition to food, medications also can be introduced through a jejunostomy tube, if necessary.
Placing a jejunostomy tube, and the decision to do so, usually falls under the category of gastroenterology, the school of medicine focusing on the digestive system, with the procedure being performed by a qualified surgeon or gastroenterologist. In many cases, a jejunostomy tube is placed to provide nutrition to patients with terminal illnesses such as cancer, so the family must be involved in the decision. If the patient is not going to recover, sometimes a feeding tube is not used, according to the wishes of the patient or the patient's family.
Using a jejunostomy tube is not limited to terminally ill patients, however. Some patients simply need supplemental nutrition in cases of severe dehydration, chronic illness that is not fatal or other situations which require short-term supplementation. In these cases, the tube will be removed after the crisis has passed. Very young children with certain gastrointestinal conditions or premature babies sometimes are fitted with feeding tubes to help supplement their diets until their digestive systems have a chance to mature or to heal properly.
During the time that the tube is used, it is important for the patient or caretakers to take proper care of the incision where the jejunostomy tube enters the body. The tube itself must be kept meticulously clean as well. Procedures for cleaning the tube and for providing food through the tube should be performed carefully in order to avoid introducing bacteria or infectious elements into the patient's system.
I had a young cousin with terminal cancer, and she had a jejunostomy tube, because she could not digest or absorb food properly any longer. She had all these specific instructions for maintaining the tube, probably because if she got an infection from it, she would likely die even sooner than predicted. It was a lot for her to memorize, but she eventually did.
I asked her if she ever felt hungry, and she said no, but she rarely felt hunger in the months leading up to the tube placement anyway. She was so nauseated most of the time that she didn’t want to think about food.
I guess it’s that way with most patients who have the tube. Something had to be dreadfully wrong with them for them to need it in the first place, so they probably don’t yearn for food.
My neighbor had to have a jejunostomy tube after he nearly died in a fall. He was eighty years old, and he had stepped out onto a rotten porch plank. He grabbed the doorknob for support, but the knob broke. He fractured several bones and had some internal damage.
He had to have the feeding tube for many months. He missed eating solid food so much, and his wife felt guilty eating in front of him, so she went to her daughter’s house to eat every day.
A nurse would come by the house to clean the tube and administer his food each day. He said it was very weird eating through his gut instead of his mouth!
When he finally had the tube removed for good, he ate his first real food in months. He had mashed potatoes, because they were easy to swallow and gentle on the digestive system.