Jejunal feeding: when is it the right thing to do?
artificial nutrition support
enteral nutrition
functional bowel disorder
gastroduodenal motility
gastroparesis
Journal
Frontline gastroenterology
ISSN: 2041-4137
Titre abrégé: Frontline Gastroenterol
Pays: England
ID NLM: 101528589
Informations de publication
Date de publication:
2020
2020
Historique:
received:
10
09
2019
revised:
05
11
2019
accepted:
06
11
2019
entrez:
5
9
2020
pubmed:
5
9
2020
medline:
5
9
2020
Statut:
epublish
Résumé
The decision to commence jejunal feeding in patients with structural abnormalities, which prevent oral or intragastric feeding, is usually straightforward. However, decisions surrounding the need for jejunal feeding can be more complex in individuals with no clear structural abnormality, but rather with foregut symptoms and pain-predominant presentations, suggesting a functional origin. This appears to be an increasing issue in polysymptomatic patients with multi-system involvement. We review the differential diagnosis together with the limitations of available functional clinical tests; symptomatic management options to avoid escalation where possible including for patients on opioids; tube feeding options where necessary; and an approach to weaning from established jejunal feeding in the context of a multidisciplinary approach to minimise iatrogenesis.
Identifiants
pubmed: 32884631
doi: 10.1136/flgastro-2019-101181
pii: flgastro-2019-101181
pmc: PMC7447283
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
397-403Informations de copyright
© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
Am J Gastroenterol. 2014 Mar;109(3):375-85
pubmed: 24419482
Semin Arthritis Rheum. 2008 Jun;37(6):339-52
pubmed: 18191990
Gut. 2019 May;68(5):804-813
pubmed: 29860241
Clin Nutr. 2018 Dec;37(6 Pt A):1967-1975
pubmed: 30290972
Gut. 2014 Dec;63(12):1972-8
pubmed: 25260920
Clin Gastroenterol Hepatol. 2018 Apr;16(4):467-479
pubmed: 28899670
Gut. 2009 Aug;58(8):1084-90
pubmed: 19136514
Clin Nutr. 2018 Jun;37(3):978-983
pubmed: 28446383
Aliment Pharmacol Ther. 2019 May;49(10):1282-1292
pubmed: 30950110
J Hum Nutr Diet. 2018 Jun;31(3):413-421
pubmed: 28960512
Gastroenterology. 2019 May;156(6):1650-1660
pubmed: 30711628
Gastroenterol Hepatol (N Y). 2018 Mar;14(3):140-145
pubmed: 29928159
Clin Gastroenterol Hepatol. 2003 Jul;1(4):264-72
pubmed: 15017667
Am J Gastroenterol. 2018 May;113(5):647-659
pubmed: 29545633
Nutr Clin Pract. 2017 Dec;32(6):769-776
pubmed: 29023196
Curr Gastroenterol Rep. 2014 Oct;16(10):409
pubmed: 25183576
Clin Gastroenterol Hepatol. 2007 Oct;5(10):1126-39; quiz 1121-2
pubmed: 17916540
Neurogastroenterol Motil. 2015 Mar;27(3):313-23
pubmed: 25428520
Scand J Gastroenterol. 2009;44(6):692-9
pubmed: 19308797
Gastroenterology. 2016 May;150(6):1380-92
pubmed: 27147122
Aliment Pharmacol Ther. 2013 Nov;38(10):1209-29
pubmed: 24102305
Gut. 2010 Dec;59(12):1592-605
pubmed: 21071581
Aliment Pharmacol Ther. 2015 Feb;41(4):360-7
pubmed: 25523288
Clin Gastroenterol Hepatol. 2016 Aug;14(8):1072-80
pubmed: 26762845