Looking after your surgical jejunostomy tube

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What is a Jejunostomy Tube?

A Jejunostomy tube is a soft tube placed through your skin into a part of your small bowel called the Jejunum. This allows feed and water to enter directly into your bowel, avoiding using your stomach.

Why do I have a Jejunostomy tube?

You have this tube because you are unable to take enough food into your stomach to keep you healthy. This could possibly be due to feeling sick, an operation that you have had or because you cannot swallow safely.

How long do I need to have my Jejunostomy tube?

This can vary depending on the reason why you have had this tube. You will be regularly reviewed by a dietitian who will advise how long you may require your tube.

How long does my tube last for?

Your jejunostomy tube can last for years if it is well cared for.

If you are able to eat and drink normally, your tube can easily be removed. This will be decided by your medical team and dietitian.

How do I clean my jejunostomy tube and the skin around it?

For the first week:

• Remove the dressing the day after your tube is inserted, this is no longer required.
• Clean the tube and site daily.
• Carefully clean under the triangle bumper and around the stitches using the Octenisan body wash undiluted. A cotton bud is useful to do this.
• Rinse and dry well.
• Apply the Mupirocin ointment around where the tube comes through the skin.

After the first week:

It is no longer necessary to use the Octenisan and Bactroban, but still clean daily with warm soapy water.

Do I need a dressing to cover the tube?

Some people like to cover the tube with a dressing to protect the stitches. We suggest a simple dressing such as Tegaderm which you can get from your GP or district nurses.

It is important to remove this dressing regularly to clean underneath.

Can I have a bath?

• For the first two days after your tube is placed do not have a bath or shower, instead wash using the Octenisan body wash.
• For the rest of the first week you may have a shallow bath or a brief shower using the Octenisan body wash. Do not soak/immerse the tube and exit site.
• After the first week, if the skin around your site is clean and dry, you may return to your normal bathing routine. If you have any
• concerns please contact either your company nurse or the nutrition nurse specialists.

What if the stitches fall out?

The surgical Jejunostomy is secured with 3 sutures in the triangular external plate.

If 1 or 2 sutures come out please

• Secure the triangle bumper of the surgical Jejunostomy tube with a dressing so that the tube does not move.
• You can continue to use the tube but should have the stitches replaced when possible.

You can continue to feed but should stop if pain or leakage occurs

If you notice that all 3 sutures have come out please

• Secure the triangle bumper of the surgical Jejunostomy tube with a dressing so the tube does not move

It is important that you do not use the tube until the stitches have been replaced

How to arrange for your Sutures to be replaced

Please contact Addenbrookes Dietician Department for the Upper GI Team on 01223 216655 or the Upper GI Nurses on 01223 596383 who can arrange suture replacement.

What else do I need to look out for?

You need to look at your site regularly to check for signs of infection. The things to look out for are:

• Redness
• Pain
• Discharge which is yellow and smelly

If you notice these signs, contact your GP, your company nurse or the nutrition nurse specialists.

It is also possible for the skin at the exit site to become pink and/or, lumpy and it may bleed easily. This may be an overgrowth of tissue which can be easily treated with a special dressing or ointment. Again, contact your GP; company nurse or the nutrition nurse specialists if you are worried.

Also look out for:

• Leaks of fluid around the tube
• Pain on feeding or flushing your tube
• New bleeding

If you have any of the above signs stop feeding immediately and telephone:

• Monday to Friday (08:30 to 16:00)
• Nutrition nurse specialists on 01223 216037
• Out of hours – Please contact your GP

If you cannot wait to be seen by your GP, please contact your local hospital’s emergency department