j-tube leaking

Boy, did my husband have a leaky j-tube site last night. We have had issues with leaking in the past, but never this bad. He had his j-tube changed from a 20 fr down to a 12fr 2 weeks ago due to a small bowel obstruction. We were told to expect some leaking around the j-tube site and we have had some that was very manageable. He only feeds at night and last night we connected him to his pump at 6:30 pm and put calmoseptine around the site and covered with 4x4 drain sponge. He woke me at 11:30 and his t-shirt was soaked with yellowish/green bile as was the gauze pad. Cleaned everything up reapplied calmoseptine and drain sponge and 25 minutes later again completely saturated. Between 11:30 last night and 5:30 this morning we went through 5 clean ups and reapplication and drain sponge changes. Nightly feeds stopped at 5:30 am and no more leaking as of 5 minutes ago. Never have had such a problem. Am keeping our fingers crossed for tonight!!!

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ooh! good luck! that is a lot of leaking. His tube is flushed enough right? I have a ten french tube and if not kept on top of, it can get kind of half clogged which can cause more drainage. I don't know if your husband "chews and spits" or eats a little orally during the day but this could also account for added drainage.

Does he have granulation tissue building up around the tube site? I prefer not to get mine taken care of unless it is affecting how the tube is acting. But sometimes that can be a reason. I am interested to know how you can run his j feeds only at night. That is the shortest time spread I have heard of. :)

Kerri tubefed since 2004

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He eats orally during the day. The tube feeds are a supplement to his oral eating. He had 90% of his esophagus removed in 2005 and they pulled up his stomach to replace the esophagus. The stomach is attached to his remaining esophagus in his neck area. As a result of this he cannot eat enough to maintain a healthy weight. He did not receive the j-tube until 2008 when his weight had dropped to 83 lbs. He is not a very big man and his normal weight is 125 and with the j-tube he has been able to reach as high as 119. There is no granulation tissue that I can see around the j-tube site. We flush his tube in the morning after his feeding stops and then again in the evening before we start the feedings. The water seems to flush through the tube relatively easy and there doesn't appear to be any clogging. When IVR put the tube in 2 weeks ago the radiologist said he wanted to change it in a month because he was worried about clogging with such a small tube. That tube change is scheduled for 2/10/12. He had a 12fr tube a year ago after small bowel resection surgery and it was clogged all the time and had to be changed to a 14fr after a month. But we never had a problem with leaking with that tube.

We do know that when he eats orally we sometimes do have increased leaking of stomach contents. But nothing like what we had last night. Then like I mentioned as soon as we stopped the feeding the leaking has stopped. It seems there is always something to deal with!!!

I might add that in 2010 before the small bowel resection surgery we spent 6 months dealing with excessive leaking. We finally found a surgeon that would look into the problem and he found that in April 2010 during a "routine" tube change the radiologist had gotten out of the established track and perforated his small bowel and that was what was causing all of the leaking. So the surgeon had to remove the existing j-tube from the left side, repair the bowel, and then place a new 12 fr on his right side. Like I said it took doctors 6 months to find this and we were very lucky he did not end up with a serious internal infection issue.

Karen

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