Naso-duodenal (ND) Or Naso-jejunal (NJ) Tubes
A naso-duodenal (ND) Tube is a soft and flexible tube that goes through the nose into the first part of the small intestines, called the duodenum. The tube is used for nutrition, fluids, or medicine.
A naso-jejunal (NJ) Tube is a soft and flexible tube that goes through the nose into the second part of the small intestines, called the Jejunum. The tube is used for nutrition, fluids, or medicine.
A ND or NJ Tube is used to feed someone who is unable to eat all their nutrition by mouth. It is most often needed for people who cannot absorb nutrients from food in their stomach. ND and NJ feedings allow the nutrition to go right into the small intestines. The small intestine is part of the digestive system between the stomach and the large intestine. The small intestine is where most of the water nutrients from food are absorbed. The small intestine is divided into 3 parts:
- The duodenum
- The jejunum
- The ileum
ND and NJ Tubes are often used short-term. Some people can eat some food by mouth but may need extra nutrition. Some people cannot handle having food or liquids in their stomach. This is sometimes due to “reflux.” Reflux is where the contents of the stomach travel back up the food pipe (esophagus) and can make you vomit. If this happens there is a risk that the feeding can be inhaled into the lungs, which can cause a chest infection. Using an ND or NJ tube can stop this from happening by bypassing the mouth, food pipe and stomach, taking the feeding right into the jejunum. Your healthcare team will tell you the reason for needing a feeding tube.
Here are some possible reasons:
- Have severe reflux or vomiting
- Cannot swallow safely
- Have digestive problems
If you need a feeding tube for a long period of time, your healthcare team may recommend a jejunal tube (J Tube) or gastro-jejunal tube (GJ Tube).
How is a ND and NJ Tube placed?
The ND or NJ Tube is passed through the nose and down the esophagus (the food pipe), through the stomach and into the small intestines. The tube can be placed by the healthcare team in the hospital or clinic while the patient is awake. It could also be placed in the radiology department. Extra equipment is used to make sure that the tube is in the correct position. This might be an x-ray or an electromagnetic placement device.
Some people can have ND or NJ feedings at home. The nurses will teach you how to give feedings, how to care for your tube, and what to do if it falls out or moves out of the nose. To learn more about how ND and NJ Tubes are placed, visit the ND and NJ Tube procedure page.
How do I feed nutrition through the tube?
People need food for health, energy, growth, and development. Food has calories, protein, carbohydrates, fat, vitamins, minerals, and water. Because the feeding goes right into the small intestine, it does not matter what it tastes like, so flavor does not need to be added.
A dietitian will work with you to make a feeding plan before you leave the hospital. Your healthcare team will help you find a feeding schedule that fits best into your family routine. This can change as your needs change.
There are many formulas or feeding choices for tube feeding. Your healthcare team will choose what is best for you.
Sometimes you may need extra water to meet daily fluid needs. Just like people drink something along with their meal, you will need some extra water with your nutrition. This is called “extra free water.” Your healthcare team or dietitian will tell you how much extra free water you need. Extra water is often given after medicines, or in between or after feedings.
The feedings go right into the small intestines, which cannot hold food in the same way that your stomach does. Feedings need to be given slowly, over a period of hours using a feeding pump. This feeding method is called continuous feeding. This will give the body time to absorb the nutrients from the feeding. Feedings can be done during the daytime or overnight.
You will be taught exactly what to do before going home. You will also be given information to take home in case you forget anything. Your healthcare team should tell you who to contact with any questions or concerns.
What supplies are needed?
You will be given all the supplies and nutrition for feedings you need at home. Supplies will be sent to you routinely and you will be told how to order these. A case worker will help get these supplies delivered to your home.
Find a place to store the supplies where they can be kept safe, clean and is easy to access. You can dispose of used supplies in the household garbage.
Always follow the instructions for using your supplies to avoid problems like infections. Infections can cause diarrhea and vomiting.
Some of the supplies may include:
- Syringes
- Feeding pump
These supplies will attach to the feeding tube. Talk to your healthcare team about your nutrition and a feeding schedule.
When does the tube get changed?
If the tube is needed for a few months, usually the tube is changed every month to every couple of months. The tube often is changed in a clinic or hospital. Ask your healthcare team how often to do this.
Instructions for Use (IFU) and Patient Guides
Below you will find a link to go to our IFU website to find all of our other patient guides and IFUs. To ensure you always have the most current information regarding your specific product, please visit our Instructions for Use website. When you arrive at the site, scroll down to view the easy-to-follow instructions and have your product part # (the REF# on your product label) ready to enter in the search box.
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