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Gastroparesis pp 341–352Cite as

Small Bowel Access for Jejunostomy Tube Feedings in Gastroparesis

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Part of the book series: Clinical Gastroenterology ((CG))

Abstract

The health care ramifications of gastroparesis (GP) can be significant. It has been estimated that patients with severe GP can have health-related costs of about US$7,000.00/month. Although there are a variety of pharmacologic, surgical, and medical device interventions available for patients with gastroparesis, there is a group of “refractory” patients who do not respond to treatment or partially respond to current treatments. It is in this group that we find patients who are at risk for fluid, electrolyte, and nutrient deficits. In addition, the erratic availability of macronutrients leads to the inability to effectively control blood sugars in patients with diabetes and gastroparesis. It is not unusual to see weight loss occur as there is a chronic inability to reliably consume calories over time. For patients who fail to stabilize their weight with diet enteral nutrition (EN) is indicated. The delivery of EN into the patient with gastroparesis would require enteral access into the small bowel in order to bypass the gastroparetic stomach. Enteral access into the small bowel can be temporary (nasoenteric) or long-term (percutaneous). In general, temporary small bowel access is used to demonstrate small bowel feeding tolerance prior to putting in a more permanent jejunostomy tube. This chapter reviews the various techniques for small bowel access and reviews the use of small bowel feeding for patients with gastroparesis.

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Author information

Authors and Affiliations

  1. Digestive Disease Center, Medical University of South Carolina, Charleston, SC, 29436, USA

    Mark H. DeLegge MD (Professor of Medicine)

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  1. Mark H. DeLegge MD
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Correspondence to Mark H. DeLegge MD .

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Editors and Affiliations

  1. School of Medicine, Department of Medicine, Temple University, N. Broad St. 3401, Philadelphia, 19140, Pennsylvania, USA

    Henry P. Parkman

  2. Paul L Foster School of Medicine, Department of Internal Medicine, Texas Tech University Health Sciences Ce, Alberta Avenue 4800, El Paso, 77905, Texas, USA

    Richard W. McCallum

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DeLegge, M.H. (2012). Small Bowel Access for Jejunostomy Tube Feedings in Gastroparesis. In: Parkman, H., McCallum, R. (eds) Gastroparesis. Clinical Gastroenterology. Humana Press. https://doi.org/10.1007/978-1-60761-552-1_28

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  • DOI: https://doi.org/10.1007/978-1-60761-552-1_28

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  • Publisher Name: Humana Press

  • Print ISBN: 978-1-60761-551-4

  • Online ISBN: 978-1-60761-552-1

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