Tell me more about g-tubes and J-tubes

Marie_LPN, RN, LPN, RN · Oct 27, 2007

PEG tube is placed in the stomach.

UNCgirl · Oct 27, 2007

A J tube is smaller in diameter than a G tube (and makes it easier to clog). They look essentially the same though. Also, since the J tube is placed in the jejunum, it bypasses the upper GI tract. I don't think you can check placement of it with an air bolus. I have seen a pt. with a G tube, J tube, and D tube all with JP drains (not used for feedings due to dead gut).

A PEG tube is a percutaneous endoscopic gastrostomy tube, placed in the stomach as Marie_LPN mentioned. It is therefore done by scope and is minimally invasive.

leslie :-D · Oct 27, 2007

no, you cannot confirm placement w/a j-tube.

with a g-tube, however, if you think about its anatomy, you could see how easily it could become dislodged or migrate.

with a tube in the jejunum (the largest part of the sm intestines), just by virtue of its width and length, it can't become dislodged, and the only place to migrate is further into the jejunum...or back into the duodenum.

much lower risks involved.

confirming placement would be much less of a concern.

leslie

ktwlpn, LPN · Oct 27, 2007

I know the difference as far as location, but does one look different than the other? Can placement be checked by air bolus for both of these?
Also, what is a peg tube? And what part of the GI tract is it inserted?

G tubes and Peg tubes are inserted through the abdominal wall into the stomach-different methods of insertion.

PEG refers to percutaneous endoscopic gastrostomy and G tube refers to direct gastrostomy tube placement. PEGs are placed by a couple of different methods-via fluoroscope or endoscopic assist-G tubes in through an incision in the abdominal wall... The tubes remain in place because a balloon on the inner end is inflated and nursing can change them. Our protocol in LTC calls for confirming placement of G tubes prior to instilling feeds or meds through visualization of gastric contents or auscultation of air bolus.

J tubes (jejunostomy) are surgically placed directly into the jejunum and sutured into place-our protocol calls for less frequent placement conformation-I think only daily prior to handing feeding (we have not had a j tube for a few years) The type of tube and method of insertion depends on the doc and the patient's diagnosis.In LTC families frequently do not understand the ramifications of a tube-"What do you mean,daddy can't have ice cream? or "What do you mean,momma is aspirating-I thought the tube would stop that?" TF is not recommended for Alzheimer's and other dementia patients-it just prolongs death..Hope this helps...

IngyRN · Oct 28, 2007

What is the difference between a Gtube (gastrostomy tube not NGT) and a PEG? I always thought they both go in the stomach.

morte, LPN, LVN · Oct 28, 2007

What is the difference between a Gtube (gastrostomy tube not NGT) and a PEG? I always thought they both go in the stomach.

they do, they differ on insertion methods.....

IngyRN · Oct 28, 2007

they do, they differ on insertion methods.....

If you dont mind explaining, what is the difference?

ebear, BSN, RN · Oct 28, 2007

IngyRN,

See reply of ktwlpn. N/G tube is typically used to keep stomach empty and is usually set to suction. It is used on a short term basis and not usually for nourishment. G-tubes and PEGS are placed in the stomach through endoscopic or radiologic methods and are designed for long-term use.

ebear

raindrop · Oct 28, 2007

So if somone pulls out their G-tube.......what should the nurse do?

And a peg tube and J-tube, if pulled out, can not be reinserted by the nurse, correct? But a G-tube can?

leslie :-D · Oct 28, 2007

So if somone pulls out their G-tube.......what should the nurse do?
And a peg tube and J-tube, if pulled out, can not be reinserted by the nurse, correct? But a G-tube can?

yes, a g-tube can be replaced at the bedside (w/md order)

a peg and j-tube, cannot.

if a pt pulls out their g-tube, immediately stick a large (18, 20+) foley in the stoma.

these stomas close up very quickly.

once you get the gtube, you can remove the foley and insert tube.

if you do not have access to gtube, keep foley in until gtube obtained.

you do not want the pt to return to the o.r. for another gastrostomy.

leslie

raindrop · Oct 28, 2007

When inserting a foley cath, how far in do you go....and how do you know when to stop? Seem like it could coil without the nurse realizing it. Is there resistance?

And sorry to sound so dumb, but I realize that the g-tube is kept in place by the baloon; should the nurse inflate the foley when it is in the stoma? How many cc?