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Tell me about nj/nd tubes

3K views 3 replies 4 participants last post by  anj_rn 
#1 ·
It looks like we're going from an ng tube to an nj/nd tube with my three month old. We discussed all the options. The developmental ped said he only sees these once or twice a year, but ds #3 is almost definitely needing this (or surgery, or just until surgery in the future.) What have others experienced with this? I knew about g-tubes and ng tubes and og tubes. I'd never even heard about nj/nd tubes until this week. Our home health nurse has no experience with them, and would love for him to have a g-tube (which makes me wonder if it's time to call the agency...)

Good, bad, ugly? What's the story?
 
#2 ·
well, it's basically the same as an NG except it passes through the stomach and into either the duodenum (nd tube) or jejunum (nj). The down side to both of these is that the placement has to be confirmed in radiology, so you can't just drop it yourself. Also you can't do bolus feeds, it has to be continuous. Chances are if you're moving to an NJ he can't handle boluses anyway. Other than that it's really not much different than an NG.
 
#3 ·
you may want to check with your DC's healthcare providers about whether it makes sense to place it through the nose (nd/nj) or directly through the abdomen (like a g-tube). either way, replacement will have to be confirmed in radiology when it goes into the duodenum or jejunum. a g-tube style placement is nice because it doesn't come out as easily and of course it isn't stuck to your child's face. but g-placements are really intended for longer term use, so if your docs think your child only needs a feeding tube for a short period (say, less than 6 months), it's not worth the surgical hassle to get a g-tube. my dd has had both nasal and gastric placements and i love the g-tube so much better. but she's had hers for over a year and counting...
 
#4 ·
So I am making the assumption that they are progressing to the nj/nd due to reflux. The tube will go through the stomach and into the duodenum or further. You have to get an x-ray to confirm placement (so it sucks that you can not put it back in). There is also usually a switch to continuous feeds since the intestine is not good for boluses.

If they do a fundiplication, usually they will just place a g-tube, but they can thread a j-tube through the same hole ( I know many people that go back and forth between the 2). We have a g-button, and we love it. I would much prefer the button than long term ng/nj/nd.
 
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