​A gastro-jejunal, or GJ-tube, can be a great aid for individuals with dysmotility, those who aspirate, and those who are losing a great deal of calories due to vomiting, but are not good candidates for a fundoplication. Rather than feeding into the stomach like G-tubes, GJ-tubes can be used to bypass the stomach and feed directly into the second portion of the small intestine. The gastric port can be used to give medications, vent air, drain fluids, and give feeds if appropriate and safe for the individual. For more general information on GJ-tubes, please visit Gastro-Jejunal (GJ) Tubes.

Switching from a G tube to a GJ tube is a relatively simple procedure. If there is already a G tube in place, the GJ tube can be placed into the same stoma, so no additional surgery is required. The switch is done in the Interventional Radiology department. A special kind of continuous X-ray called fluoroscopy is used to correctly place the GJ. Some hospitals allow parents to be in the room and others do not.

Also, sedation is used by some facilities, but others do not use any type of sedation. While the procedure is not usually very painful, it can be uncomfortable, and some children have trouble staying still or experience anxiety during the procedure. Initial placement can be more difficult than subsequent GJ-tube changes. In subsequent replacements, a guide wire can be threaded through the tube that is already in place so that the new tube can easily be put into the correct position.

Common Question:

Does GJ Placement Hurt?

It Can.

For most children, GJ placement or replacement is mildly uncomfortable. There may be tugging at the site when the old tube is removed, and there may be a feeling of fullness or mild discomfort when the new tube is being put in place. More common than pain is a feeling of anxiety.

Common Question:

Is a GJ Permanent?

Not always.

The GJ-tube is not necessarily permanent. Many kids who need to have a GJ do not need to stay on it forever. Some of the conditions that make the GJ necessary improve with time, and transitioning back to gastric feeds is possible. And if it doesn’t work out, it can easily be switched back to a G-tube.

Things to be aware of before switching

You should trial continuous G feeds if you haven’t already. You will be continuously feeding the J anyway. If continuous G feedings are failing, then the move to the GJ is a good one.

Switching from a G-tube to a GJ-tube may not necessarily stop a child from refluxing or vomiting. What it can do is prevent the loss of calories from vomiting by allowing the formula to bypass the stomach so that it cannot be vomited up.

One of the challenges of a GJ-tube is that the J portion holds the pylorus partially open, and that means that bile from the small intestine can potentially seep into the stomach. This can be problematic for an individual with chronic vomiting, severe reflux, or aspiration of reflux. Having a GJ-tube is a godsend for a child who has any of these problems because the stomach can be vented without interrupting feeds. If bile reflux is a problem, the stomach can be vented continuously to prevent the bile from being vomited or refluxed and aspirated. Some doctors prefer for the bile to be re-fed through the J port, but others prefer to replace it with an equal volume of Pedialyte. It may depend on the amount of drainage, the patient’s condition and tolerance. Other times, IV fluids are the best option for rehydration and replacement of lost electrolytes.