What is Percutaneous Endoscopic Jejunostomy

Percutaneous endoscopic jejunostomy is a surgery to place a feeding tube in the upper part of the small intestine (jejunum).

You may have this procedure if you will not be able to get enough nutrients from eating or drinking for more than 30 days, such as if you have severe brain or stomach problems or some types of cancer.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or members of your family have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Damage to other structures or organs.
• Allergic reactions to medicines.
• Leaking around the feeding tube.
• Tearing (perforation) of the jejunum
• Diarrhea.

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

Medicines

Ask your health care provider about:

• Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
• Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.

General instructions

• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Plan to have someone take you home from the hospital or clinic and stay with you for 24 hours.

What happens during the procedure?

• An IV tube may be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
  • An antibiotic medicine to prevent infection.
• A long, thin, flexible telescope (endoscope) will be passed into your mouth, through your stomach, and into your jejunum.
• A small incision will be made in your abdomen.
• A feeding tube will be placed through the incision.
• The endoscope will be used to guide the feeding tube into the correct position.
• The feeding tube insertion site will be checked for leaking or bleeding.
• A bandage (dressing) may be placed around the feeding tube.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
• You will be given supplies or told where to get supplies for feedings and for caring for your tube.
• Do not drive for 24 hours if you were given a sedative.
• You may have:
  • Pain and tenderness around your feeding tube.
  • A sore throat.
  • Slight drainage around your feeding tube.

Percutaneous Endoscopic Jejunostomy, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Pain and tenderness around your feeding tube.
• A sore throat.
• Slight drainage around your feeding tube.

Follow these instructions at home:

Activity

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Take short walks often. Try to take at least two 10-minute walks each day.
• Do not drive for 24 hours if you were given a medicine to help you relax (sedative).

Incision care

• Do not shower for the first 2 days after the procedure.
• Do not take a bath, swim, or use a hot tub for the first 2 weeks after the procedure.
• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Clean the skin around your feeding tube every day. You may need to use a certain kind of solution to do this.
  • Apply any ointments to the area only as told by your health care provider.
• Check your incision area every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Make sure you know when and how to start tube feeding. Contact your health care provider if you have any questions.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have pain that gets worse or does not get better with medicine.
• You have constipation or diarrhea that does not improve with treatment.
• You feel bloated.
• You feel nauseous.
• You have more redness, swelling, or pain around your incision.
• You have more fluid or blood coming from your incision.
• Your incision feels warm to the touch.
• You have pus or a bad smell coming from your incision.
• You have a fever.

Get help right away if:

• You have a fever that lasts longer than 3 days.
• You have severe pain.
• You have coughing and trouble breathing.
• You vomit blood.
• Your feeding tube is blocked, you cannot rinse out (flush out) the tube, or it comes out.
• You become disoriented, confused, or very tired.