PT  - JOURNAL ARTICLE
AU  - Peter Paine
AU  - Marie McMahon
AU  - Kirstine Farrer
AU  - Ross Overshott
AU  - Simon Lal
TI  - Jejunal feeding: when is it the right thing to do?
AID  - 10.1136/flgastro-2019-101181
DP  - 2020 Sep 01
TA  - Frontline Gastroenterology
PG  - 397--403
VI  - 11
IP  - 5
4099  - http://fg.bmj.com/content/11/5/397.short
4100  - http://fg.bmj.com/content/11/5/397.full
SO  - Frontline Gastroenterol2020 Sep 01; 11
AB  - 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.