A Deep Dive on the Types of Tube Feeding – The What, Where and How
Nearly half a million children and adults in the U.S. use a feeding tube. It can be a critical lifeline, enabling you to get the nutrition, fluids or medications you need when you can’t meet those needs by mouth. When you or a loved one are just starting out on tube feeds, it can feel overwhelming and isolating, but it’s important to remember that you’re not alone.
Once you’ve mastered the basics of tube feeding, it’s helpful to understand some further details about this new way of nourishing yourself – from “NG-tubes” to “J-tubes” and everything in between.
What are the Different Types of Feeding Tubes?
Starting on tube feeds can raise a lot of questions, such as, “Is there only one type of feeding tube?” or “What’s a PEG tube versus a G tube, or an NG tube versus an NJ tube?” The type of tube you use will depend in part on how long you’re likely to need it. Tubes inserted through the nose – known as “NG-tubes” and “NJ-tubes” – are generally intended for short-term use, while tubes placed directly into your stomach or intestines are typically meant for longer-term use. These include G-tubes, PEG-tubes and J-tubes, and these can remain in place as long as they’re needed.
Here’s a closer look at some of the most common types of feeding tubes:
- A nasogastric tube (NG-tube) is a thin flexible tube of polyurethane or silicone rubber that this passed through the nose, throat and into the stomach. It is for short-term use, generally for a few days up to 6 weeks.
- A nasojenjunal tube (NJ-tube), similarly to an NG-tube, is a small tube inserted through the nose that passes through your gastrointestinal tract. It goes beyond the throat and stomach, emptying into the jejunum, the upper part of the small intestine.
- A gastrostomy tube (G-tube) is a surgically placed so that the tube passes through the abdominal wall directly into the stomach and are usually for longer-term feeding, (4 weeks or longer). This tube is typically placed by a surgeon.
- A Percutaneous endoscopic gastronomy tube (PEG-tube) is a type of G-tube named after the type of procedure that’s used to put it into place: a long, flexible instrument called an endoscope. A doctor makes a small incision in your upper abdomen, places the tube through the incision and connects the tube to your stomach. This tube is typically placed by a gastroenterologist.
- A jejunostomy tube (J-Tube) is a surgically placed tube that is inserted directly into the jejunum, which is the upper portion of the small intestine. It is typically placed by a surgeon.
- A Percutaneous endoscope jejunostomy tube (PEG-J) is a tube that is endoscopically inserted directly into the jejunum. It is typically placed by a gastroenterologist.
One of the primary differences in feeding tube types is where the tube empties. NG-, G- and PEG-tubes empty into the stomach, while NJ- and J-tubes connect instead to the small intestine. Since NJ, J-tube, and PEG-J bypass the stomach, these tubes may be indicated after certain surgeries, or for the treatment of digestive diseases or issues.
Feeding Tube Terminology
No matter what type of feeding tube you use, or how you administer your feedings, you’ll likely need to learn a few new words as you begin to use and care for your tube. Understanding these important terms will help you begin to feel more comfortable and confident with your new routine:
- Bolster - a round disc that lies against your abdomen on the outside of your body to help keep your feeding tube in place.
- Feeding port - the opening in your feeding tube where formula is inserted.
- Medicine port – the opening where you put medicine in your feeding tube.
- Stoma – the physical site where the feeding tube connects to the body (e.g., your stomach).
- Bolus feeding – taking in a large amount of formula, usually through a syringe, within a short period of time several times a day, similarly to how you would consume meals and snacks throughout the day.
- Continuous feeding – formula that is administered using a pump or a bag to move the food into your feeding tube at a slow, steady rate (for example, over a period of 8–24 hours.
- Gravity bag – a bag that contains tube feeding formula. This is used for gravity feedings, in which a bag is suspended in the air on a hook or pole, and gravity causes the formula to flow into the feeding tube.
- Feeding pump - a pump that pushes the formula through your feeding bag.
- Large volume syringe – a syringe that holds 50-60 milliliters of liquid. This can be used to administer formula in bolus feedings as well as water to flush the tube (see below).
- Plunger - the part of a syringe that pushes water or formula into your tube.
- Flush – to rinse the inside of your feeding tube with liquid. You will flush your tube with warm water after each feeding, and before and after giving yourself any medicines.
If you’re feeling confused or overwhelmed by your new tube feeding routine, reach out to your doctor or dietitian with any questions or concerns you have. And remember, be kind and patient with yourself. Like any life change, getting adjust to tube feeding takes time, and it’s okay to lean on family, friends, and your healthcare team for support.