For those of you who aren’t familiar, there are 4 different types of feeding tubes- NG, NJ, G, GJ.

“N” stands for nasal, which means that NG and NJ tubes enter through your nose rather than your abdomen. These are common “first tubes”, since they don’t leave scarring. I had an NJ at first, but once we realized my illness was longterm we made the surgical switch. The difference between “G” and “J” is where the nutrients (for me this is a broken down formula, however sometimes people can tolerate more significant mixtures like blended meals) goes into- either the GASTRIC (stomach) or the JEJUNAL (small intestine).

So, NG= Nasal Gastric, NJ= Nasal Jejunal, G= Gastric, GJ= Gastric Jejunal.

I have a GJ, which means I have a surgically placed tube in my abdomen that feeds into my small intestine. There are two ‘ports’ on my GJ button- one is a “G” and the other a “J”. I hook up to the “J” for all of my feeds, but use the “G” for things like medications and water.

The long part of a GJ-tube, which is placed into the small intestine, can sometimes migrate out of place. When this happens, it typically curls up into the stomach. In some rare cases it can extend upward into the esophagus. We call these “tube flips”.

Some tubes never flip. When I was a patient at The Mayo Clinic in MN their enteral feed specialists were really emphasizing that I should get a separate “J” port because “GJ”s have a tendency to flip. At the time I had never experienced a tube flip, and The “J” tube was really big and looked really heavy, so I pretty much said no thanks. Unfortunately, this is my second year in a row, ironically THE SAME WEEK, where my GJ has flipped up and coiled around in my stomach, resulting in excruciating pain and vomiting. A common cause for this happening is frequent vomiting or dry-heaving, because you’re basically retching the tube out of it’s place. And due to my illness, I vomit/retch/dry heave several times a day, so it makes sense that my tube has been flipping.

Symptoms of a GJ tube being out of place are

Vomiting formula
Feeding intolerance
Abdominal Pain
Formula coming out of the “G” port
If you feel like somethings wrong.

The first time my tube flipped last year, I had no idea what that felt like and it wasn’t even on my mind. But trusting your gut when you feel like something isn’t right is SO important when you’re dealing with things that nobody else can see or feel. Worst case scenario, you go in for an x-ray and your tube placement is perfectly fine. Better to do that than not check!

What is a "tube flip"?