Can You Throw Up With a GJ Tube? Understanding the Risks and Causes

November 21, 2025 •

3 min read

While GJ tubes are often used to prevent aspiration and manage feeding intolerance, studies show that vomiting can still occur in a significant percentage of patients. This can happen for several reasons, including mechanical issues, improper placement, and underlying medical conditions.

Quick Summary

It is possible to vomit with a GJ tube due to factors like tube migration, blockage, rapid feeding rates, or underlying gastrointestinal issues. Understanding the causes and recognizing symptoms is crucial for effective management and preventing serious complications like aspiration.

Key Points

Vomiting is Possible with a GJ Tube: While the tube reduces the risk, it is not a fail-safe against vomiting, which can occur due to various complications.
Common Cause is Tube Migration: The jejunal port can migrate back into the stomach, causing feeding intolerance and vomiting. This requires immediate medical attention.
Blocked or Clogged Tubes: Obstructions from formula or medication can cause backflow and increased pressure, leading to nausea and vomiting.
Manage Feeding Intolerance: Feeding too quickly or using an unsuitable formula can result in vomiting. Slowing the rate and adjusting the regimen are key strategies.
Utilize the Gastric Vent: The gastric port of the GJ tube can be vented to release trapped air and fluid, which helps reduce nausea and bloating.
Proper Positioning is Crucial: Keeping the patient's head elevated during and after feeds can help minimize reflux and the chance of vomiting.

Can a Gastrojejunostomy (GJ) Tube Prevent All Vomiting?

A gastrojejunostomy (GJ) tube is a medical device designed to provide nutrition directly into the small intestine (jejunum) while bypassing the stomach. It's used for conditions like gastroparesis or severe acid reflux. While it helps decompress the stomach and reduce reflux, a GJ tube doesn't completely eliminate the risk of vomiting.

Common Reasons for Vomiting with a GJ Tube

Several factors can lead to vomiting in patients with a GJ tube:

Tube Migration: The jejunal part of the tube can move back into the stomach, especially with forceful movements. Feeds then go into the stomach instead of the small intestine. Formula or drainage from the gastric port can indicate this.
Tube Blockage: Clogs in either port can increase pressure and cause vomiting. This can be due to medication or thick formula.
Feeding Intolerance: The body may not tolerate the formula or the feeding rate, leading to nausea and vomiting.
Underlying Medical Conditions: Existing conditions like gastroparesis or new issues like infections can still cause vomiting.
Increased Abdominal Pressure: Coughing or straining can potentially cause the tube to move or trigger vomiting.

Recognizing the Signs and Symptoms

Watch for these signs of potential GJ tube complications:

Increased vomiting
Leaking formula from the tube site
Abdominal pain or swelling
Fever or infection at the tube site
Diarrhea
Change in the tube's external marking

Troubleshooting and Management Strategies

Managing vomiting involves identifying the cause and taking appropriate steps, often in consultation with healthcare professionals:

Check Tube Placement: If vomiting occurs, particularly with formula in the gastric port, suspect migration. An X-ray can confirm placement.
Adjust Feeding: Slowing the rate or volume of feeding can help if intolerance is suspected. A dietitian can provide guidance.
Vent the Gastric Port: Regular venting can release gas and stomach contents, reducing nausea and reflux.
Maintain Upright Position: Keeping the patient's head elevated during and after feeds reduces reflux risk.
Proper Tube Care: Flushing the tube with warm water prevents blockages.

Comparison of G-Tube vs. GJ-Tube Vomiting Risk

Here's a comparison of vomiting risks:


Feature	Gastrostomy (G) Tube	Gastrojejunostomy (GJ) Tube	Evidence
Feeding Location	Stomach.	Jejunum, bypassing stomach.
Vomiting Mechanism	Delayed gastric emptying, reflux.	Tube migration, blockages, fast feeding.	,
Primary Use Case	Tolerates stomach feeding.	Severe gastroparesis, reflux, aspiration risk.
Vomiting Incidence	Higher with gastric issues.	Lower reflux risk, but mechanical issues can cause it.
Aspiration Risk	Higher, especially with poor gag reflex.	Lower, but still possible with vomiting.
Management Strategy	Medication, feeding schedule, diet, venting.	Checking placement, controlling feeding speed, venting gastric port.	,

Conclusion

A GJ tube provides nutritional support and helps reduce aspiration risk, but it does not completely prevent vomiting. Potential causes include tube migration, blockages, and feeding intolerance. Monitoring for symptoms, checking tube placement, adjusting feeding, and using the gastric port for venting are key management steps. If vomiting persists, contacting a healthcare team is essential.

Seeking Medical Attention

Persistent vomiting, suspected tube migration, or other signs of feeding intolerance should prompt contact with a healthcare provider. Severe vomiting, distress, or suspected aspiration require emergency care.

{Link: BAPEN website https://www.bapen.org.uk/education/nutrition-support/enteral-nutrition/management-of-enteral-feeding-complications/}.

Frequently Asked Questions

A patient with a GJ tube can still throw up for several reasons, including tube migration back into the stomach, blockages, feeding intolerance due to formula or rate, and underlying medical issues like gastroparesis that persist despite the tube.

Stop the feeding immediately. Check for signs of tube migration, such as a change in the tube's external marking, and use the gastric port to vent the stomach. Contact a healthcare provider for guidance, as the tube may need to be repositioned.

Prevention involves ensuring correct tube placement, using the gastric port for regular venting, administering feeds at an appropriate rate and volume, and keeping the patient's head elevated during and after feedings.

A tube migration is often indicated by an increase in vomiting, formula draining from the gastric port, or a change in the position of the external marking on the tube. Any suspected migration should be confirmed by a healthcare professional with an X-ray.

Yes, venting the gastric port can help reduce nausea, bloating, and vomiting by releasing excess gas and fluid that builds up in the stomach. This can be done by attaching a syringe barrel or drainage bag to the gastric port.

Yes, healthcare providers may prescribe antiemetic medications like ondansetron (Zofran) to manage nausea and vomiting. It's crucial to follow the clinician's instructions and inform them if symptoms persist.

Not always, but it should be taken seriously. Seek immediate medical attention if vomiting is forceful, persistent, or accompanied by signs of distress, tube dislodgement, or aspiration, such as coughing or choking.