jordan

Gastric Tube in the Stomach when you have had Gastric Bypass Surgery

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Hi Doctor,

I wanted to get your opinion on this topic. If one has had a Gastric Bypass Surgery, is it possible to have a Gastric Tube put into their stomach if their condition so requires in the future for feeding and medications. If it is possible, are there any special considerations for the surgeon who will be performing the Gastric Tube procedure. Also, would there be any limitations on the types of medications being delivered through the Gastric tube given that the patient has had a gastric bypass procedure in the past. What other advice would you provide on this topic.

 

Thank You   

Edited by jordan

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Dear Jordan,

A nasogastric tube (NG tube) is a tube that is passed through the nose, down the esophagus, and into the stomach. A nasojejunal tube is longer. It passes through the nose, through the stomach, and into the jejunum (after gastric bypass).

There are two reasons to pass such tubes: decompression and feeding. The first reason is to take pressure off of the stomach and intestines by removing fluid or air. This might be needed if there were an obstruction blocking the intestine further down. The second reason is for feeding. A feeding tube can deliver nutrition and medication into the stomach or Roux limb if a patient can't take food by mouth or if there is a narrowing in the connection between the stomach and jejunum (gastrojejunostomy).

Medications can be administered through a feeding tube or NG tube if they can be prepared as a liquid or thin mixture. Pills that are simply crushed and mixed with water can be a problem if they clog the tube.

An NG tube used to decompress the intestine is a fairly heavy duty tube. It is reasonably stiff and must be inserted carefully by a knowledgable nurse or physician. There is some risk that the tube can catch in the jejunum near the gastrojejunostomy and can even perforate the jejunum. In some cases the patient's physician may ask the radiologist to pass the NG tube under x-ray guidance. That way the radiologist can be sure it goes to the correct location and does not cause damage. An NG tube used for decompression can be left in place for a few days or week or two, but eventually causes quite a bit of irritation to the nose.

A feeding tube has a fairly narrow diameter and is very flexible. It is usually passed through the nose, through the stomach, and into the jejunum by a radiologist using fluoroscopy (active x-ray guidance). Sometimes it is even necessary to ask a gastroenterologist to use endoscopy to guide the tube though a tight gastrojejunostomy. A  feeding tube is usually well tolerated and can be left in place for weeks or longer. 

Other types of tubes include gastrostomy tubes and jejunostomy tubes. These can be inserted via surgery or endoscopy through the skin and directly into the stomach or jejunum. Gastrostomy tubes can be used to decompress the stomach or for feeding. Jejunostomy tubes are used for feeding. Both types of tubes are usually well tolerated and can be left in place for prolonged periods of time.

Dr. Callery

 

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Thank you for your response Doctor. To make sure I understand this correctly.....One Can has a Gastric Feeding Tube surgically implanted directly into the stomach even though one has had a Gastric Bypass surgery in the past.   

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Yes. A gastric feeding tube can be inserted into the lower (excluded) portion of the stomach. The tube is usually inserted using laparoscopic technique on an out patient or overnight stay basis. The tube can be used for feeding or it can be used to decompress the stomach. The tube may be used for feeding within a day in most cases.

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