Adults

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Naso-Jejunal (NJ) Tubes

Before the Procedure

Before the tube placement, you’ll be told what is going to happen, why, and what to expect. You will need to give verbal consent to have the tube placed.

It’s always good to have a loved one around before, during (when appropriate), and after the tube is placed, for moral support. If you are a caregiver of the person getting the tube and are allowed to be present for the placement and you know your loved one can be a little uncooperative, you might be called on to help hold them while the tube is being placed. If you do not feel comfortable helping when called on (which is ok), you can voice this to the care team.

During the Procedure

An NJ tube can be placed in a variety of ways. You may be taken to a special procedure room in the IR (Interventional Radiology) department, may be taken after the tube was placed to get an x-ray, or may not have to be taken to another room at all, based on the equipment available at the facility. When a special room isn’t needed, placement is done at your “bedside.”

It’s possible that the tube will be placed at the bedside using the CORTRAK. This device allows the staff to watch the tube’s passage on a screen. If used, a triangle-shaped sensor unit placed on the lower chest area. If the facility you’re in does not have this device, nurses may still place the tube at bedside, repositioning you as needed, during the procedure. The tube will pass through the nose and throat, into the esophagus, down into the stomach and finally be guided through the small opening (called a pylorus) into the small intestine. The tip of the tube may be dipped in water or lubricating jelly to help it travel through the nasal passage easier.

It may take a few minutes to get the placement where it needs to go. This could be uncomfortable, but you may be allowed to sip on water from a straw, which might help. Gagging some when the tube is in the throat is normal.

Before use, the tube’s placement will be confirmed. If a stylet was used, it will be removed once the tube is in place and the tube will be secured to the cheek or with another securing device.

After the Procedure

It’s normal to have some gagging and discomfort at first. This doesn’t mean anything’s wrong and eventually you’ll get used to the tube. Positive thinking is very beneficial during this stage. Remind yourself frequently that many people have done this successfully and you can too. Good words of encouragement are: “I can do this! I am going to do this!”

A good rule of thumb is to brush your teeth or rinse your mouth several times a day to keep your mouth healthy. You’ll also want to ask if it’s OK to drink liquids or eat food with an NJ tube.

Before you leave, make sure you have all the take-home supplies you need or know the plan on where to get them, such as tape and syringes. Your care team will teach you how to give medications and flush the tube. It’s recommended to flush the tube every four hours during the day to prevent clogging. Your care team will also teach you how to fill the feeding bags and give the feedings using a pump.

You may need to give some medications down the NJ tube. If so, find out if the medications need to be diluted first. Flush the tube before and after giving medications.

Your First Day at Home

The first thing you’ll want to do when you get home is find a place to store supplies. You’ll also want to find a clean space for preparing the formula.

Using a backpack to carry the pump and formula allow for more mobility, especially as you return to your normal routine. Gently loop the tubing and tape the loop to prevent accidental tripping over the tubing. If you have pets or younger children around, take steps to protect the feeding bag tubing from them. Check the tube and make sure it remains securely taped.

Keep your urgent, emergent problems document handy in case you have questions.
Remember: the first day at home after any big change is going to require some adjustment. But before long, you’ll become more use to what to do and how to do it and you’ll develop a new routine that’s second nature to you.

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