G tube -vs- J tube?

Hello,
I have a 19 yo dd who has severe stomach emptying delay. Daily nausea, (even with Reglan, or Nexium or Phennegran, she can't take Zofran) . constipation (regrardless of what she takes for it and how often).

She is on strong narcotic medication for 2 rare health issues that cause severe daily pain. SO i know this slows the gut a great deal

There are days all she does is throw up, others days it is complete nausea only, some days she can eat one small meal eeven with all the meds she is taking for the nausea.

We noticed when she was in the hospital last month for back surgery that while she was on the IV she had NO nausea at all for 4 days. It was great for her. As soon as they started introducing foods. liquids/ soft then regualr, here came the constant nausesa and eventaully throwing up.

Her old Gastro has aged her out since she is 19. We are searching for a new one/ a motility specialists in the Dallas Texas area.

My question concern it this: the last GI we saw had the stomach emptying test done on her, I sat with the tech and watched the monitor the whole 90 minutes. The computer registered her stomach only emptying at 16% after 90 m inutes. The tech showed me and I saw that the food was still in her stomach after this time, it never moved out. She said it registered at 16% only emptied out. However once we got the report, the tech actually called me at home and told me that the Radiologist had her re evaluate the scan, and change some parameters so that the scan was 'normal'. The tech told me I could 'get a second opinion". I took it that I should. But I am confused how the parameters could of changed, the food was there I saw it and it did not go any where. How could this happen? (1) Any suggestions?

(2) I am afraid of the answer here, but, since she had 'good' results with the IV only nutrition, then once food was introduced the nausea and throwing up returned, does this mean, in your humble opinions that she may be a canditate for a g-tube or J-tube. I am not familiar with the difference in the two. However I am questioning which ever one goes into the stomach as this seems to be where her problems are.

(3) If she should ever have to have a tube put in does this mean she can not eat / drink by mouth at all?

Thanks for you help in all this.

LaQuita
www.caringbridge.org/visit/shea

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I am so glad that you found us here and welcome to this great group.

I am so sorry that your daughter has had to go through so much at such a young age. Our young that suffer with health problems saddens me so much. Life just isn't fair espically for them that haven't even had a chance to really experience and enjoy there lives.

I agree with you that you should get a second opinion. It does sound weird that you can go from a 16% to normal on a G.E.T. something just sounds wrong.

Has her doctor thought about putting her on TPN, since she did well on the IV? I am currently on TPN myself for my GP about a month now and it has helped me alot. I have gained 10 pounds and I feel so much better as far as dehydration and nutrition wise. I don't eat much as most of the time it makes me sick but I try and eat something everyday to keep my stomach from getting weaker.

I am currently waiting to see if I qualify for a gastric pacemaker. I personally don't want to have any tubing but I know sometimes we don't have choices. Maybe there is a possiblity that her doctor would try her on the TPN first. It is a pain as far as bathing and that it limits you to some things. But it saved my life so I am grateful for that. But I do have a love hate relationship with having it.

I know there are several on here that have the tubing so I can't help you on that. I hope you can get your answers you are looking for here. I will keep your daughter in my prayers.

Whispper

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Dear LaQuita,
I will try to address your questions about the tubes, as I have had experience with both types. A g-tube is a tube that goes into the stomach as the "g" stands for gastric which comes the Greek word for stomach. The j-tube goes into the part of the small intestine called the jejeunum which accounts for the "j". If your daughter is having such trouble with her stomach, it would probably be best to try j-tube feedings as this type allows her to bypass her stomach. Your doctor may want to check how well her bowels work first to make sure she can handle it. Sometimes, a nasal tube can be tried on a temporary basis just to see how her system might handle it before any surgery to place a permanent tube occurs. A g-tube can still be useful to someone who is receiving j-tube feedings. When I had my first g-tube, I was using it to drain my stomach in order to help prevent vomiting and abdominal discomfort. At that time, I was also completely dependent on j-tube feedings. Although I was not taking anything by mouth, the stomach can still produce its own acids and such.

As regards a comparison between TPN and the tubes, TPN has the disadvantage of involving more risk due to infections and possible liver damage, and I have always been encouraged to try to stick to the tube feedings if possible. However, I have also heard of people who have been on TPN for years and even decades and who have managed to live a pretty normal life. This is why it is important to keep in close communication with your doctor to make sure that the best decisions regarding your daughter's own personal needs in her unique situation. One can still eat orally while on TPN or while receiving tube feedings. These can often serve as a supplement to what one can get in by mouth. While my first experience with either method of feeding had me completely dependent on each one, more recently and after a transplant, I have used both to supplement my oral diet in order to try and gain weight.

I also think that you might want to get a second opinion about your GES study. Unfortunately, the test is not more widely standardized which makes it more difficult to compare one test conducted one place with another performed somewhere else. I hope that you can get some answers that will make more sense.

I am sorry that your daughter is having to go through all of this, but I am glad that she has you reaching out to support her. I do not know what I would do without my own parents while I deal with illness. I will be sure to keep you both in my thoughts and prayers. I hope this week will bring you some new reasons to smile. Best of wishes.

Warm regards,
Bobbiejo

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Hi, I am trying to email you directly about the g vs. j tube discussion. I have added you as a friend and still can't get a message to you. This is why I get so frustrated at this site some days, it is hard with my screen reading program to navigate. Please email me at msmac11955@yahoo.com and lets talk.

Thanks

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I wonder if her nausea/vomiting might be related to dehydration. I have severe problems with it; beyond GP problems. I'm still trying to figure out my triggers for nausea. I wonder if that's my problem too. I have trouble getting fluids in. I am on an IV drip all day every two weeks - at least.

Reglan has a lot of side effects. I'm still stumped at the FDA & AMA for allowing this med to stay on the market.

I give myself shots of phenergan, oral doesn't work for me and if I chew it, it numbs my lips, mouth, esophagus. I see why it works in the stomach.

Tech's' are not suppose to give a patient or anybody a diagnosis. They are only trained to do the scan. Once the scan is taken, it is the radiologist who knows how to read it. It is illegal for the tech to give you any information. You cannot rely on the tech, they learn some things simply by years of work... But if the superior finds out that tech will be fired.

If you don't trust this radiologist, you need a second opinion. All scans will be read by a radiologist and they are the only one who can write the report. This report now has gone to all her doctors. A second and third opinion are needed.

You can get her records, oops, she can get her records; or she can sign a paper to have you added on. I would strongly recommend this. She is only 19 and ill to boot.

You need to get a confirmed report that she has GP. I don't think a doctor would put in any tube without a firm diagnosis. I fear you are back at the beginning. Yes, you can still drink, eat with a tube. I asked this question too.

I'm sorry this has happened. My husband reads scans but always defers to the radiologist. You have to get a good diagnosis all over again. Boo!

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I am hoping you have received some answers by now, but I have severe gastroparesis, and have a J-Tube. If indeed you daught has gatroparesis, there are medications to try, before trying something as invasive as surgery. If indeed she needs tube feeding due to gastroparesis, she will have to have a J-Tube placed. The other person that posted to be sure her bowels are operating correctly first is right. I had a lot of difficulty with my bowels being slow when I first got my tube, which prolonged my hospital stay. And yes, I would have her GES redone. A lot of things effect gastric emptying, but if indeed only 16% of her food passed in 90 min. it sounds like there is a problem. I had multiple GES done before I had my tube placed, just to be sure I was making the right descion. Good Luck.

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I am hoping you have received some answers by now, but I have severe gastroparesis, and have a J-Tube. If indeed you daught has gatroparesis, there are medications to try, before trying something as invasive as surgery. If indeed she needs tube feeding due to gastroparesis, she will have to have a J-Tube placed. The other person that posted to be sure her bowels are operating correctly first is right. I had a lot of difficulty with my bowels being slow when I first got my tube, which prolonged my hospital stay. And yes, I would have her GES redone. A lot of things effect gastric emptying, but if indeed only 16% of her food passed in 90 min. it sounds like there is a problem. I had multiple GES done before I had my tube placed, just to be sure I was making the right descion. Good Luck.

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Kristin-
I too have severe gastroparesis, and after almost 20 years of suffering, I am considering a j-tube. My GI doc here in Atlanta thinks it is a good idea, since I am struggling so badly with food. I have to taks lots of zofran and tramadol on a daily basis just to eat to keep my weight up. I am 5'5 and 108 lbs. right now. I read your entry about having a j-tube, and was wondering how well it was working for you. I feel the best when I don't eat, so bypassing my stomach sounds like a great temporary idea. Any suggestions or personal experiences would be great. My GI wants me to have a laparoscopically surgically placed J-tube. How was yours done? Thanks for your help.
gijen

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