Which type of feeding tube is used to administer enteral nutrition?

October 31, 2025 •

4 min read

According to the American Society for Parenteral and Enteral Nutrition (ASPEN), enteral nutrition is indicated for patients who cannot meet their nutritional needs orally but have a functional gastrointestinal (GI) tract. Several types of feeding tubes exist to administer this crucial support, and the choice depends on the anticipated duration of therapy, the patient's condition, and the GI tract's functional status.

Quick Summary

This guide details the various feeding tubes for administering enteral nutrition, categorizing them by placement and duration, from short-term nasal tubes to long-term abdominal tubes. It compares their uses, placement procedures, and key considerations for healthcare providers and patients.

Key Points

Short-Term Tubes: Nasoenteral tubes like NG, ND, and NJ are used for temporary feeding (less than 4-6 weeks) and are inserted through the nose.
Long-Term Tubes: Percutaneous tubes (G-tube, J-tube, GJ-tube) are used for longer feeding needs and are surgically or radiologically placed directly into the stomach or small intestine.
Aspiration Risk: For patients with a high risk of aspiration, tubes that bypass the stomach, such as NJ or J-tubes, are often preferred.
Placement Methods: Nasal tubes are placed at the bedside, while percutaneous tubes require endoscopic, radiological, or surgical procedures.
Specific Needs: GJ-tubes provide dual functionality, allowing for stomach drainage and jejunal feeding simultaneously.
Management is Key: Regular care, including flushing and monitoring the insertion site, is crucial to prevent common complications like clogging, dislodgement, and infection.
Multidisciplinary Approach: The decision on the best tube is a collaborative effort involving doctors, dietitians, and other healthcare professionals.

Understanding Enteral Nutrition and Access

Enteral nutrition involves delivering specialized liquid formulas containing essential nutrients directly into the GI tract via a tube. This is necessary for patients with a functional digestive system who cannot safely eat or swallow, such as those with neurological disorders, certain cancers, or following major surgery. The selection of the appropriate enteral access device, or feeding tube, is a critical decision made by a healthcare team. Tubes can be broadly categorized into short-term (nasoenteral) and long-term (percutaneous) options, each with distinct placement methods, indications, and care requirements.

Short-Term Nasoenteral Tubes

For patients requiring nutritional support for less than four to six weeks, a flexible tube inserted through the nose is typically used. These tubes are generally placed at the bedside and are removed once the patient's oral intake is sufficient.

Nasogastric (NG) Tube

A nasogastric tube is inserted through the nose, down the esophagus, and into the stomach. This is the most common type of short-term feeding tube and is used when the patient has normal gastric emptying and a low risk of aspiration. It is also used for gastric decompression to relieve pressure from fluids or gas.

Nasoduodenal (ND) and Nasojejunal (NJ) Tubes

These tubes are passed through the nose, past the stomach, and into the first (duodenum) or second (jejunum) part of the small intestine. They are often used for patients at a higher risk of aspiration, severe reflux, or those with impaired gastric motility (gastroparesis), as feeding into the small intestine reduces the chance of regurgitation. Placement is typically guided by fluoroscopy or endoscopy.

Long-Term Percutaneous Tubes

When enteral feeding is needed for more than four to six weeks, a more permanent tube placed directly into the stomach or small intestine through the abdominal wall is necessary. These require a minor surgical, endoscopic, or radiological procedure for insertion.

Gastrostomy (G-tube)

This tube is inserted directly into the stomach via a small incision in the abdomen. It is used for long-term feeding in patients with conditions affecting swallowing but with a functioning stomach. There are a few types of gastrostomy tubes:

Percutaneous Endoscopic Gastrostomy (PEG) tube: Placed endoscopically, this is a common method for creating a long-term feeding access.
Radiologically Inserted Gastrostomy (RIG) tube: Positioned using X-ray guidance, often for patients unable to undergo an endoscopy.
Button/Low-Profile G-tube: A more discreet, skin-level device that uses an extension set for feeding.

Jejunostomy (J-tube)

Placed directly into the jejunum through the abdominal wall, a J-tube is used when gastric feeding is not possible due to a proximal bowel obstruction, gastroparesis, or high risk of aspiration. Feeding through a J-tube is typically delivered slowly and continuously with a pump, as the small intestine cannot hold large volumes at once.

Gastrojejunal (GJ-tube)

This is a single tube with two ports, one ending in the stomach and the other extending into the jejunum. It allows for simultaneous gastric decompression and jejunal feeding, which is useful for patients needing both functions.

Comparison of Enteral Feeding Tubes


Feature	Nasogastric (NG) Tube	Percutaneous Endoscopic Gastrostomy (PEG) Tube	Jejunostomy (J-tube)	Gastrojejunal (GJ) Tube
Typical Duration	Short-term (<4-6 weeks)	Long-term (>4-6 weeks)	Long-term (>4-6 weeks)	Long-term (>4-6 weeks)
Placement Method	Bedside insertion via nose	Endoscopic procedure	Surgical or radiological procedure	Radiological or endoscopic procedure
Target Site	Stomach	Stomach	Jejunum (small intestine)	Stomach (drainage) & Jejunum (feeding)
Best For Patients With	Functional GI tract, normal gastric emptying, low aspiration risk	Functional GI tract, normal gastric emptying, swallowing difficulties	Impaired gastric motility, high aspiration risk, proximal obstruction	Need for both gastric decompression and jejunal feeding
Feeding Schedule	Bolus or Continuous	Bolus or Continuous	Continuous (often)	Continuous (J-port)
Visibility	Visible externally on the face	Concealable under clothing	Concealable under clothing	Concealable under clothing

Factors Guiding Tube Selection

Several factors influence the selection of a feeding tube. The medical team will evaluate the patient's condition, including their neurological status, risk of aspiration, and overall prognosis. The expected duration of the feeding support is a primary determinant, with short-term needs managed by nasoenteral tubes and long-term needs requiring percutaneous access. Pre-existing conditions, such as gastrointestinal motility disorders or recent surgeries, also play a crucial role in deciding whether feeding should be gastric or jejunal. A multidisciplinary team, including dietitians, gastroenterologists, and nurses, collaborates to ensure the most appropriate and safest option is chosen for the patient.

Benefits and Potential Complications

Enteral feeding is generally safer and less expensive than parenteral (intravenous) nutrition and helps preserve GI tract function. It provides vital nutrients for healing and recovery. However, complications can occur and vary by tube type.

Common complications include:

Aspiration Pneumonia: Occurs if feed enters the lungs. More common with gastric feeding, particularly with nasogastric tubes.
Tube Dislodgement or Clogging: Requires proper flushing and securement to prevent.
Infection and Leakage: Risks at the insertion site for percutaneous tubes, necessitating good hygiene and site care.
Gastrointestinal Issues: Symptoms like diarrhea, constipation, nausea, or cramping can arise, often managed by adjusting the feeding formula or rate.
Buried Bumper Syndrome: A rare but serious complication of PEG tubes where the internal bumper erodes into the gastric wall.

These risks are carefully managed by the healthcare team through proper tube care, patient education, and monitoring. More information on tube feeding guidelines is available from reputable sources like the National Center for Biotechnology Information.

Conclusion

Multiple types of feeding tubes are available to administer enteral nutrition, each tailored to specific patient needs, conditions, and anticipated duration. Short-term nasoenteral tubes like NG, ND, and NJ are suitable for temporary support, while long-term needs are met by percutaneous options such as G-tubes, J-tubes, and GJ-tubes. The choice of tube is a critical medical decision that balances a patient's clinical needs, risk factors like aspiration, and quality of life. Proper selection and diligent management by a dedicated healthcare team are essential for ensuring safe and effective nutritional support.

Frequently Asked Questions

The primary difference is the duration of use and placement method. A nasogastric (NG) tube is for short-term use (less than 4-6 weeks) and is inserted through the nose. A gastrostomy (G-tube or PEG) is for long-term use and is placed directly into the stomach through the abdominal wall via a procedure.

A doctor would choose a jejunostomy (J-tube) if gastric feeding is not tolerated or is unsafe. This may be due to conditions such as delayed gastric emptying (gastroparesis), a high risk of aspiration, or an obstruction in the stomach or upper intestine.

Yes, feeds administered through a jejunal tube are typically given continuously using a pump over a longer period. This is because the small intestine cannot handle the large volumes of formula that the stomach can, reducing the risk of dumping syndrome.

Common complications include tube clogging or dislodgement, infection at the insertion site, leakage, and gastrointestinal issues like nausea, diarrhea, or cramping. Aspiration pneumonia is a more serious risk, particularly with gastric tubes.

A 'low-profile' tube, or button, is a discreet, skin-level device used for long-term feeding. Its compact size makes it less prone to dislodgement and more comfortable for active individuals, and it can be easily concealed under clothing.

Proper NG tube placement is most reliably confirmed by an X-ray immediately after insertion. Bedside methods like measuring the tube's external length and checking the pH of gastric aspirate are used for routine checks, as the 'whoosh test' is unreliable.

Yes, many medications can be administered through a feeding tube. It is important to crush tablets (if appropriate) or use liquid forms and flush the tube with water before and after administration to prevent clogging.

A gastrojejunal (GJ) tube has two separate ports. One port empties into the stomach and can be used for drainage or venting, while the other port extends into the jejunum for feeding.

Generally, yes. Enteral nutrition is preferred because it is safer, more cost-effective, reduces the risk of infection, and helps preserve the function of the gut.