Advice after your nerve block for surgery
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Introduction
This leaflet explains how to look after your nasojejunal (NJ) tube at home, including any problems which can occur. If you have any questions, please contact your dietitian or nutrition specialist nurses.
Why Do I Need an NJ Tube?
You may have had an NJ tube inserted because it is unsafe to have food by mouth or because you are struggling to take enough food. You may also have trouble with emptying your stomach, digestion or being at high risk of aspiration. The NJ tube should therefore provide additional feed and fluid to meet your nutritional needs.
General Information on NJ Feeding
Comfort and Safety
- After the initial position of the NJ tube has been confirmed, use a permanent marker pen to mark the tube close to the nose
- Before feeding, always check that the tube is securely taped to the face and that the length of the tube which is visible is the same as usual
- If a longer length of tube is visible, this may indicate that the tube is not correctly positioned. Contact the hospital ward where your tube was placed for advice
During Feeding
- If any sickness or breathing difficulties are experienced during feeding, stop the feed immediately
- Avoid lying flat while feeding. Sit up if possible. If feeding in bed, the upper back and head should be raised on extra pillows aiming for an angle of 30-45 degrees. This helps to prevent indigestion/ regurgitation/ heartburn.
- A feeling of ‘fullness’ during feeding may indicate that feed is being administered more quickly than recommended. Try reducing the rate by 10-20mls/h
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
Care of Nasojejunal Tube
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The NJ tube must be ‘flushed’ or rinsed with cooled, boiled water before and after any feed or medication is put down the tube
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Flush with cooled boiled water every six hours during rest periods
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This ensure that it will not become blocked. The dietitian will advise you on how much water to use for this
Medicines
- If it is necessary to have medication through the NJ tube, make sure these are prescribed in liquid form if possible. If medication is only available in tablet form, seek advice from your pharmacist on how to make a solution by crushing your tablets
- Check with your pharmacist that your medication is suitable to be administered into this part of your digestive system
- Tablet particles can lead to tube blockages, so your 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.
Mouthcare
- 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
Further Information
Additional information can be obtained from PINNT. This is a support group for patients receiving nutrition via their veins or through a feeding tube. Telephone or fax on 01202 481625, between the hours of 9.30am and 16.30pm. You may also log on to their website www.
Care of Enteral Feed and Equipment in the Home Environment
Feeds
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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
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In winter months it is advised not to store feed in garages or garden sheds for risk of freezing
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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).
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Rotate stock of feed, using up ‘old’ stock before using a new delivery
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Powdered feeds should be kept dry and at room temperature
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Once opened, any liquid feed which is not used immediately must be kept covered and refrigerated for up to 24 hrs (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)
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Any feed not used within 24 hours of opening must be discarded
Washing equipment
| Item | Use for | Cleaning method | Discard after |
| Giving sets | 24 hours | Not applicable | 24 hours |
| Feed resovoirs | 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 | 10 days |
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Some disposable equipment may be washed and re-used
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Items which may be re-used after cleaning should be washed well in hot water containing detergent and then rinsed thoroughly in clean water
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When washing syringes separate the chamber and plunger
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After rinsing, allow to dry by inverting syringes on a clean surface or kitchen paper. Do not use dishcloths or tea towels.
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Store equipment in a clean container
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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.
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Ensure feeding pump is cleaned regularly with warm soapy water. If feed is spilled onto pump, clean immediately.
Handling Feed and Equipment
- Hand hygiene is very important. Effective handwashing 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 described next 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 |
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| 2. Palm to palm with fingers |
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| 3. Palm to back with fingers interlaced |
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| 4. Fingers clasped |  |
| 5. Rotational rubbing of both thumbs |
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| 6. Tips of fingers opposite palms |
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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
Nasojejunal 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, try to remove the blockage by drawing back on the tube using a syringe to aspirate the blockage
- Try to flush the rube 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
- The tube may not clear on the first attempt. Repeated attempts may be necessary.
If still no success:
- Contact the Nutrition Support Nurses at the hospital where your tube was placed
- If it is outside of working hours please contact the out of hours GP service who may refer you to your local A & E
- If your NJ tube was placed in X-ray, please inform A & E when you attend
Please note - never try to force water into the NJ 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
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It it is outside of working hours please contact the out of hours GP or attend your local A & E
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If your NJ tube was placed in X-ray, please inform A & E when you attend
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
- Check that feed is not being given more quickly than is recommended by your Dietitian
- Contact the Dietitian for advice if the problem persists
Constipation
- Check that sufficient fluid is being given (refer to nutrition plan)
- Discuss with the Dietitian, it may be possible to change the feed
- It may be a side effect of other medication
- Contact your GP if the problems do not resolve within a few days
Nausea or Vomiting
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Stop the feed in the case of any vomiting
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Check the feed is not being given more quickly than is recommended by your Dietitian
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Check the feed volume is not larger than recommended
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Check that the feeding position is correct (i.e. not lying flat), aim for a 30–45-degree angle
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Attempt to recommence feeds as soon as possible
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If feeds not tolerated contact your Dietitian or GP for advice
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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 and/or Homeward nurse will telephone or visit you at regular intervals to review your progress and make any necessary changes to your feeds
- 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 during office hours
Contact Information
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DIETITIANS: The Dietitians may be contacted during office hours 8.30am to 4.00pm, Monday – Friday. TEL: 0300 6153232 |
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HOSPITAL NUTRITION NURSES: If feeding tube was placed at Frimley Park Hospital: If feeding tube was placed at Wexham Park Hospital: |
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NUTRICIA HOMEWARD: Nutricia Homeward nurses can be contacted during working hours Monday to Friday for advice and support. Outside office hours, contact the Nutricia advice line, who will put you in touch with the on call nurse who may be able to advise you over the telephone. Nutricia Homeward: TEL: 0800 093 3672 |
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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/041
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.