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Difference Between G-tube and J-tube

The gastrostomy feeding tube (G-tube) and jejunostomy feeding tube (J-tube) are used to provide nutrients to patients who have a functional gastrointestinal tract, but can’t take adequate amounts of food through the mouth.

What is G-Tube?

G-tube is used for people, needing long-term nutritional support (more than four to six weeks). It is the most commonly used feeding tube. It is inserted in the stomach via a small abdominal incision.

In case of small intestine blockage, the G-tube can be used for gastric drainage. It can also be vented out to release stomach gases.

There are three ways to perform a G-tube surgery:

  • Endoscopically: by creating the opening from the inside via scope,
  • Surgically: through small incision, with the help of a laparoscope,
  • Surgically: through a larger incision.

The endoscopic G-tube surgery is the preferred method at many hospitals. However, G-tubes are still placed surgically, for example in patients with anatomic abnormalities.

Most of the G-tubes can be changed at home, the procedure is not complicated.

There are several types of G-tubes. The appropriate G-tube for each patient is determined by the gastroenterologist or the surgeon.

The G-tubes are appropriate for patients with swallowing difficulties, due to esophageal atresia, stroke, tracheoesophageal fistula, etc. They can decrease the risk of aspiration pneumonia.

The most commonly used G-tube types are:

  • Percutaneous endoscopic gastrostomy tubes (PEG tubes) and Long tubes: one-piece tubes held in position by a bumper or by a retention balloon.
  • Buttons or Low profile tubes: tubes without a permanently attached long tube. They have an extension set, connected when needed and disconnected after use. When the extension set is disconnected, the button lies relatively flat against the skin.

A complication of the presence of a G-tube can be the formation of granulation tissue, which can be irritating, painful and bleed easily.

What is J-Tube?

J-tube is a medical device, inserted into the jejunum (the middle part of the small intestine). Its aim is to provide the necessary medications and nutrition. J-tubes are less commonly used than G-tubes, and are applied when G-tubes cannot be used due to some kind of obstruction, e.g. anatomical issues. J-tube is preferred when the tube will be placed for permanent use. In some rare cases J-tubes can be changed at home, but typically radiology is required for the replacement.

J-tubes, like G-tubes, can be long tubes or buttons.

The methods of placing a J-tube are:

  • Percutaneous endoscopic jejunostomy (PEJ): a direct placement with the use of an endoscope.
  • Laparoscopic or open surgery: the tube is placed through an incision directly into the small intestine.
  • Gastric bypass procedure or Roux-en-Y: a small “limb” is created of a portion of the jejunum and is attached to the abdominal wall. The J-tube is placed in the created limb. The method is complicated and affects the anatomy of the jejunum. It allows for a stable tract and easy tube changes, which can be made at home.

The jejunum is with a smaller width, compared to the stomach. It doesn’t have fundus or an expandable area. For this reason slow, continuous feeding with a pump is required. The feeding takes 16-20 hours per day. For some patients a 24 hour feeding may be required.

The J-tubes are appropriate for patients with chronic vomiting, low gastric motility, or at high risk for aspiration. They are also installed to individuals to whom G-tubes are not recommendable. They can decrease the risk of aspiration pneumonia.

J-tubes’ stomas leak around the tube more often than the G-tubes’. As a consequence more problems with irritation and granulation tissue may be expected.

Difference Between G-tube and J-tube

  1. Definition of G-tube and J-tube

G-tube: G-tube is a medical device, inserted in the stomach via a small abdominal cut.

J-tube: J-tube is a medical device, inserted into the middle part of the small intestine (the jejunum).

  1. Use of G-tube and J-tube

G-tube: G-tube is used to provide the necessary medications and nutrition, to release stomach gases, and for gastric drainage.

J-tube: J-tube is used to provide the necessary medications and nutrition.

  1. Placement of G-tube and J-tube

G-tube: The G-tubes can be placed endoscopically and surgically. The surgical placement can be through a small incision with the help of a laparoscope, or through a larger cut.

J-tube: The J-tubes can be placed endoscopically, laparoscopically, via gastric bypass procedure or Roux-en-Y.

  1. Changing of G-tube and J-tube

G-tube: For most of the G-tubes change at home is possible.

J-tube: For most of the J-tubes change at home is not possible.

  1. Applicability of G-tube and J-tube

G-tube: The G-tubes are appropriate for patients with swallowing difficulties, due to esophageal atresia, stroke, tracheoesophageal fistula, etc.

J-tube: The J-tubes are appropriate for patients with chronic vomiting, low gastric motility, or at high risk for aspiration.

  1. Duration of feeding  for G-tube and J-tube

G-tube: Feeding through G-tube is faster than with J-tube because the stomach has expandable area and fundus.

J-tube: Slow continuous feeding with a pump is required. The feeding takes 16-20 hours per day. For some patients a 24 hour feeding may be required. 

  1. Complications from G-tube and J-tube

G-tube: A complication of the presence of a G-tube can be the formation of granulation tissue, which can be irritating, painful and bleed easily.

J-tube: J-tubes’ stomas leak around the tube more often than the G-tubes’. As a consequence more problems with irritation and granulation tissue may be expected.

 

Summary of G-tube versus J-tube:

  • The gastrostomy feeding tube (G-tube) and jejunostomy feeding tube (J-tube) are used to provide nutrients to patients who have a functional gastrointestinal tract, but can’t take adequate amounts of food through the mouth.
  • G-tube is a medical device, inserted in the stomach via a small abdominal cut.
  • J-tube is a medical device, inserted into the middle part of the small intestine (the jejunum).
  • G-tube is used to provide the necessary medications and nutrition, to release stomach gases, and for gastric drainage. J-tube is used to provide the necessary medications and nutrition.
  • The G-tubes can be placed endoscopically and surgically. The J-tubes can be placed endoscopically, laparoscopically, and via gastric bypass procedure or Roux-en-Y.
  • Most of the G-tubes can be changed at home, while most of the J-tubes cannot be changed at home.
  • The G-tubes are appropriate for patients with swallowing difficulties, due to esophageal atresia, stroke, tracheoesophageal fistula, etc. The J-tubes are appropriate for patients with chronic vomiting, low gastric motility, or at high risk for aspiration.
  • Feeding through G-tube is faster than with J-tube because the stomach has expandable area and fundus.
  • A complication of the presence of G-tube and J-tube can be the formation of granulation tissue, which can be irritating, painful and bleed easily. More complication can be expected to result of the presence of a J-tube.

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References :


[0]O'Gorman, E. Complete Tubefeeding: Everything You Need to Know about Tubefeeding, Tube Nutrition, and Blended Diets. 2012. Print. 

[1]Rolandelli, R. Clinical Nutrition: Enteral and Tube Feeding. Michigan: Elsevier Saunders. 2005. Print. 

[2]Silkroski, M., P. Guenter. Tube Feeding. Gaithersburg: Aspen Publishers, Inc. 2001. Print.

[3]Image credit: https://upload.wikimedia.org/wikipedia/commons/thumb/c/c1/Diagram_showing_the_position_of_a_percutaneous_jejunostomy_feeding_tube_CRUK_342.svg/603px-Diagram_showing_the_position_of_a_percutaneous_jejunostomy_feeding_tube_CRUK_342.svg.png

[4]Image credit: https://commons.wikimedia.org/wiki/File:Gastric_Feeding_Tube_Infant.png#/media/File:Gastric_Feeding_Tube_Infant.png

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