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This leaflet explains about how to look after your jejunostomy tube at home, including any problems which can occur. If you have any further questions, please contact your dietitian or nutrition specialist nurses.
General Information on Jejunostomy Tube Feeding
A jejunostomy tube is a tube which is inserted directly into the beginning of the small bowel namely the jejunum. It may be referred to as a ‘Jej’ or a ‘Surgical Jej’.
Why Do I Need a Jejunostomy Tube?
You may have had a jejunostomy tube inserted because, due to your condition, you are unable to eat all the nutrients you need. You may be experiencing reflux where food is reverting back into your oesophagus from the stomach, or you may be required to rest your stomach to allow it to heal.
Comfort and Safety
- If any sickness or breathing difficulties are experienced during feeding, stop the feed immediately
- A feeling of ‘fullness’ during feeding may indicate that feed is being administered more quickly than recommended. Try reducing the rate by 5-10mls/hr, remember this will mean the total amount of feed will take longer to run. Speak to your Dietitian if you are unsure.
Care of the Jejunostomy Tube
- The jejunostomy tube must be ‘flushed’ or rinsed with cooled, boiled water before and after any feed or medication is put down the tube
- Flush with cooled boiled water every 4-6 hours. This ensures that it will not become blocked. The dietitian will advise you on how much water to use for this
- The triangle with stitches holding your tube in place should not be removed unless advised by your hospital consultant, if they fall out the tube will need restitching in place as otherwise there is nothing retaining the tube.
- The tube should not be rotated or advanced into the bowel. Care should be taken to ensure the tube is not displaced
Hygiene
- Always wash your hands carefully and dry hands on a clean towel or paper towel before handling feeds or feeding tubes.
- Handle and store feed and equipment in accordance with recommendations
Medicines
- If it is necessary to have medication through the tube, make sure these are prescribed in an appropriate format e.g. soluble/dispersible tablets or liquids
- Please be aware that some liquid medications can be sticky and may need diluting to avoid tube blockage—please discuss with your pharmacist
- Medication can lead to tube blockages, so your Jejunostomy tube must be flushed with cooled boiled water before, between and after each different medication that is given. Usually, this would entail a 50ml flush of cooled boiled water prior to giving the medication, 10ml flushes between each separate medication, followed by a final flush of minimum 50ml cooled, boiled water. The dietitian will advise you of any change to these quantities
Skin Care
- The skin around the jejunostomy tube should be kept clean and dry in order to prevent any soreness or infection
- Washing the area daily with a gentle soap and water is usually all that is needed
- Do not use talcum powder or creams on this area unless prescribed by your GP. Dressing or gauze are best avoided under normal circumstances
- Any soreness, swelling, odour or discharge should be reported to your Nutricia Homeward nurse, Nutrition Nurses or your GP
Mouth Care
- It is important, even when not eating or drinking, to take good care of your teeth and mouth
- Teeth and gums should be brushed as usual
- Lip salve can prevent dryness or soreness around the mouth
- It is important to visit the dentist at usual intervals
Routine Changes of Tube
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With appropriate care and maintenance, the jejunostomy tube can remain functional for one year or longer
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The timing of tube replacement will be determined by your clinician, based on clinical need.
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Your dietitian or Enteral nutrition nurse will advise you on when and where the replacement will take place.
Stopping feeding
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If regular feeding via the tube is not required, it is recommended that the tube be flushed at least twice daily with 50 ml of water to help prevent blockage.
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If you are able to meet your nutritional requirements through oral intake, your clinician will discuss the option of removing the tube.
Further Information
Additional information on feeding can be obtained from PINNT (Patients on Intravenous and Nasogastric Nutrition Therapy).
This is a support group for patients receiving nutrition via their veins or through a feeding tube. You may visit their website: www.
Care of Enteral Feed and Equipment in the Home Environment
Feeds
- All prescribable feeds have an expiry date on the pack. Check the date and never use feed if the expiry date has passed
- Before opening feed gently shake the pack
- Liquid feeds in packs are sterile until opened and therefore do not need refrigeration but should be stored at room temperature (away from heat or direct sunlight)
- In winter months it is advised not to store feed in garages or garden sheds for risk of freezing
- Rotate stock of feed, using up ‘old’ stock before using a new delivery
- Powdered feeds should be kept dry and at room temperature
- Once opened, any liquid feed which is not used immediately must be kept covered and refrigerated for up to 24 hours (feed should be given at room temperature, never given straight from the fridge, so take feed out of the fridge 30 minutes prior to using)
- Any feed not used within 24 hours of opening must be discarded
- Some disposable equipment may be washed and re-used
|
ITEM |
USE FOR |
CLEANING METHOD |
DISCARD AFTER |
|
Giving set |
24 hours |
Not applicable |
24 hours |
|
Feed reservoirs |
24 hours |
Not applicable |
24 hours |
|
Re-usable syringes (syringes issued on the ward are not re-usable) |
|
Immediately after use, wash and rinse following instructions below |
7 days |
|
Extension sets |
|
Immediately after use, wash and rinse following instructions below |
14 days |
- Items which may be re-used after cleaning should be washed well in hot water containing detergent and then rinsed thoroughly in clean water
- When washing syringes separate the chamber and plunger
- After rinsing, allow to dry by inverting syringes on a clean surface or kitchen paper. Do not use dishcloths or tea towels
- Store equipment in a clean container
- The syringes should be purple oral/enteral syringes. Syringes issued by the wards are not re-usable, but the syringes provided once you are at home, should be re-usable
- Ensure feeding pump is cleaned regularly with warm soapy water. If feed is spilled onto pump, clean immediately
Water
- We use cooled boiled water for all patients at home unless advised otherwise
- Water can be boiled and kept in a covered container in the fridge for a 24-hour period and then changed daily
- Water should be given at room temperature - never give straight from the fridge
Handling Feed and Equipment
- Hand hygiene is very important. Effective hand washing will reduce the risk of infection. Prior to handling feeds or equipment hands should be thoroughly washed with soap and hot water and dried on a clean towel. Wash hands thoroughly. The six-stage procedure on the next page will help you to effectively decontaminate all areas of your hands
- Disposable gloves are not needed by family members but should be worn by others (e.g. dietitians, district nurse) when handling feed and equipment
- Careful, clean handling of feed and equipment will reduce risk of bacterial contamination
Six stage hand washing guide
| 1. Palm to palm |  |
| 2. Palm to palm with fingers |  |
| 3. Palm to back with fingers interlaced |  |
| 4. Fingers clasped |  |
| 5. Rotational rubbing of both thumbs |  |
| 6. Tips of fingers opposite palms |  |
Jejunostomy Feeding – Problems Which May Occur
Tube Blockage
This should not happen if the tube is always flushed as instructed.
However, should the tube become blocked:
- First draw back tube contents to remove blockage
- Try to flush the tube with warm water (not hot)
- Use the syringe plunger to apply gentle pressure to withdraw contents of the tube, try a push/pull action
- Gently squeeze/roll blocked section of tube between finger and thumb to help disperse the blockage
If no success:
-
Try to flush the tube with soda water or one teaspoon of bicarbonate of soda mixed with 10ml warm water and leave in the tube for approximately 20 minutes
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The tube may not clear on the first attempt. Repeated attempts may be necessary
If still no success:
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Contact the Enteral Nutrition nurse in your local hospital-within working hours
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If it is outside of working hours please contact the out of hours GP service or attend your local A&E
Please note – never try to force water into the jejunostomy tube as this may split the tube.
If The Tube Falls Out
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If you are using the tube to administer fluid or medication as well as feed, it is possible that you may become dehydrated, or suffer from symptoms that your medications usually control
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Please contact Enteral Nutrition Nurse at your local hospital as soon as possible within working hours
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If it is outside of working hours, please attend your local A&E
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Replacement should be arranged as soon as possible due to the risk of the tract closing.
Lost sutures:
• Please contact your surgical/oncology nurse or the Enteral Nutrition Nurse at your local hospital as soon as possible during working hours. It is important to have the sutures replaced promptly due to the risk of the tube becoming dislodged or falling out.
• If it is outside of working hours, please attend your local A&E.
Dehydration
- This is when the body needs more water. It can be caused by a variety of reasons such as fever, not taking enough water or hot weather
- If you feel thirsty, have dry lips, feel weak and are not passing very much urine, then you may be dehydrated
- Overcome this by flushing the tube with extra cooled, boiled water prior to and at the end of feeding
Fullness or Discomfort During Feeding
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Check that feed is not being given more quickly than is recommended by your dietitian
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Contact the dietitian for advice if the problem persists
Nausea or Vomiting
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Stop the feed in case of any vomiting
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Check the feed is not being given more quickly than is
recommended by your dietitian -
Check the feed volume is not larger than recommended
-
Check that the feeding position is correct (i.e. not lying flat), aim for 30-45 degree angle
-
Attempt to recommence feeds as soon as possible. If feeds not tolerated contact your GP or dietitian for advice
Diarrhoea
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Diarrhoea sometimes occurs as a result of taking antibiotics. This may continue for a few days, after the course of antibiotics has been completed. Do not stop taking the antibiotics or feed;
discuss with your GP or dietitian -
Check that the feeding rate is as recommended by your dietitian
Constipation
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Check that sufficient fluid is being given (refer to nutrition plan)
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Discuss with the dietitian, it may be possible to change the feed
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It may be a side effect of other medication
-
Contact your GP if the problems do not resolve within few days
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Important Information The Trust may share your information with other NHS health and social care providers to assist in giving you the best care possible. Where we share your information with these organisations, they are subject to strict information sharing protocols and have a legal duty to keep it confidential and secure. Only information that is required and appropriate to support your care and treatment will be provided |
Future Contact
Once you are at home, the dietitian will telephone or visit you at regular intervals to review your progress and make any necessary changes to your feeds. Nutricia Homeward nurses can support you with training and troubleshooting.
Please contact the dietitians between appointments if you have any queries or problems relating to:
- Your feeding plan
- Your feeding tube or other equipment
- Any problems during feeding (e.g. discomfort, nausea, vomiting, diarrhoea)
If there are any problems with the delivery of feeds or giving sets, please contact Nutricia Homeward in office hours.
Contact information
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DIETITIANS: For any questions regarding your feeding regime, including tolerance, timings or potential side effects, the Dietitians may be contacted during office hours 8.30am to 4.00pm, Monday – Friday. Tel: 0300 6153232 |
|
HOSPITAL NUTRITION NURSES: For tube related issues, the Hospital Nutrition Nurses may be contacted during office hours 8.30am to 4.00pm, Monday – Friday. If feeding tube was placed at Frimley Park Hospital: Nutrition Nurses at Frimley Park Hospital: TEL: 0300 613 9087 - 07393 240680 If feeding tube was placed at Wexham Park Hospital: Nutrition Nurses at Wexham Park Hospital: TEL: 07775 008920 - 07393265825 |
|
NUTRICIA HOMEWARD: Nutricia Homeward nurses can be contacted during working hours Monday to Friday for advice and support. Nutricia Homeward: TEL: 0800 093 3672 |
|
EMERGENCY: In case of an emergency, if the dietitian or nutrition nurse cannot be contacted, please contact your GP. If you are unable to administer your feed for any length of time, your body may become dangerously short of fluid. If this happens outside of working hours, please contact the out-of-hours GP service which may refer you to your local A&E department. |
Contact us
If you have any queries relating to this information, please contact the Dietetics service.
About this information
Service:
Dietetics
Reference:
DT/045
Approval date:
1 April 2026
Review date:
1 April 2029
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.