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Jejunostomy Feeding Guide

Jejunostomy feeding provides benefits like maintaining GI structure and function while reducing toxins and bacteria. It has indications for when upper GI feeding is contraindicated or for GI motility disorders. Absolute contraindications include bowel obstructions or inability to absorb nutrients. Complications can be mechanical, gastrointestinal, or metabolic. Proper tube securing, positioning, flushing, and monitoring can prevent mechanical issues while formula selection, rate, and contamination prevention can reduce gastrointestinal complications.

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Adith Fileanugraha
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10K views13 pages

Jejunostomy Feeding Guide

Jejunostomy feeding provides benefits like maintaining GI structure and function while reducing toxins and bacteria. It has indications for when upper GI feeding is contraindicated or for GI motility disorders. Absolute contraindications include bowel obstructions or inability to absorb nutrients. Complications can be mechanical, gastrointestinal, or metabolic. Proper tube securing, positioning, flushing, and monitoring can prevent mechanical issues while formula selection, rate, and contamination prevention can reduce gastrointestinal complications.

Uploaded by

Adith Fileanugraha
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Jejunostomy Feeding

Benefits
• Maintains gastrointestinal structure and
function
• Reduces translocation of toxins and possibly
bacteria
• Less expensive than parenteral nutrition
therapy
• Fewer complication than parenteral
Indications
• Feeding contraindicated for upper GI tract
• Gastric motility disorders
• History / risk of reflux or aspiration
Contraindications
Absolute
• Complete bowel obstruction
• Severe small bowel ileus with abdominal
distention
• Complete inability to absorb nutrients through
the GI tract
Contraindications
Relative
• Severe postprandial pain
• Short bowel syndrome
• Intractable vomiting
• Severe diarrhea
Complications
• Mechanical
• Gastrointestinal
• Metabolic
How to prevent mechanical
complications?
• Properly secured jejunostomy tube
• Head of bed elevated 30  – 45 
• Pump ensures safe delivery
• Monitoring gastric residuals
• Maintain tube patency
Maintain tube patency
• Flush regularly, every 3-4 hours with 25 ml
warm water
• Use feeding tube only for formula delivery
• Flush the tube with water before and after
administering medications
How to prevent gastrointestinal
complications?
• Not attributed to enteral feeding
– Medical condition
– Pre existing GI condition which reduces the
bowels functional capacity
– Medications
– Atrophy from lack of use
How to prevent gastrointestinal
complications?
• Related to enteral feeding :
– Formula composition
– Administration method (rate and volume)
• Full strength formula slowly, gravity or infusion pump
• Continous feeding
– 25 ml/hour ; 24 hours/dayor during part of the day or night
– Formula contamination
Administration
• Infusion Pump Indications
– Small intestine feeding
– Fluid restrictions
– Risk of aspiration
– Need for precise flow rate
– Nocturnal feeding
– Infants and small children

• Gravity Infusion Indications


– Suitable for intermittent feeding
– Ambulatory patients
– Gastric feeding
Prevention of Tube Feeding
Contamination
• Recommended formula hang time :
– 8-12 hours for open systems
– 24 hours for pre-filled containers
Summary
• Enteral nutrition should always be the first
option considered
• Use post-pyloric route if gastric access not
possible
• Nasogastric route should be used for short
term feedings
• Surgical or percutaneous enterostomies
should be the choice for long term cases and
for laparotomy patients

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