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Review
Jejunal feeding: when is it the right thing to do?
  1. Peter Paine1,
  2. Marie McMahon1,
  3. Kirstine Farrer2,
  4. Ross Overshott3,
  5. Simon Lal4
  1. 1Department of Gastroenterology, Salford Royal NHS Foundation Trust, Salford, Salford, UK
  2. 2Dietetics, Salford Royal, Salford, UK
  3. 3Department of Liaison Psychiatry, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
  4. 4Intestinal Failure Unit, Salford Royal NHS Foundation Trust, Salford, UK
  1. Correspondence to Dr Peter Paine, Salford Royal NHS Foundation Trust, Salford M6 8HD, UK; peter.paine{at}srft.nhs.uk

Abstract

The decision to commence jejunal feeding in patients with structural abnormalities, which prevent oral or intragastric feeding, is usually straightforward. However, decisions surrounding the need for jejunal feeding can be more complex in individuals with no clear structural abnormality, but rather with foregut symptoms and pain-predominant presentations, suggesting a functional origin. This appears to be an increasing issue in polysymptomatic patients with multi-system involvement. We review the differential diagnosis together with the limitations of available functional clinical tests; symptomatic management options to avoid escalation where possible including for patients on opioids; tube feeding options where necessary; and an approach to weaning from established jejunal feeding in the context of a multidisciplinary approach to minimise iatrogenesis.

  • artificial nutrition support
  • enteral nutrition
  • functional bowel disorder
  • gastroduodenal motility
  • gastroparesis
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Footnotes

  • Contributors PP, MM, KF, RO and SL all wrote sections of the article and commented and revised other sections. PP is the guarantor of the overall content.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; externally peer reviewed.

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