Type of access | Usefulness | Disadvantages |
Nasogastric tube | Gastric decompression in acute management | Not meant for long-term use Large tube size often causes discomfort Is a poor choice for feeding due to delayed gastric emptying as significant gastroesophageal reflux can occur |
Nasoduodenal/nasojejunal tube | Used to give trial feedings to determine if jejunal feedings are tolerated. May be acceptable if there are no other options. | Not for long-term use Vomiting may expel the tube into the stomach |
Gastrostomy tubes | May be used for venting of secretions to decrease vomiting and fullness | Poor choice for feeding due to delayed gastric emptying May prevent proper electrode placement for gastric electrical stimulation |
PEG-J or Jet-PEG | Allows the patient to vent gastric secretions to decrease/prevent persistent emesis Provides jejunal feedings New PEG-Js have distal feeding ports to reduce duodenogastric reflux | Migration of the J-tube extension into stomach Pyloric obstruction from J-tube May prevent proper electrode placement for gastric electrical stimulation |
Jejunostomy (surgical, endoscopic, radiographic) | Stable access for reliable jejunal nutrient delivery Avoids gastric penetration that would interfere with proper electrode placement for gastric electrical stimulation | Cannot vent stomach |
Dual gastrostomy and jejunostomy | Two sites — one for venting and one for enteral nutrition | Increased risk of leakage, infection Cosmetic issues |
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