Gastroparesis, reflux, failure to thrive/feeding intolerance



There are many conditions that may end up requiring long term access to the stomach or small bowel to provide nutritional support and symptom relief. Gastroparesis is a condition where the stomach does not empty properly and can lead to recurrent vomiting. Severe reflux can lead to aspiration and chronic lung problems in susceptible patients. Patients that are unable to maintain adequate oral intake for many reasons can also require help with nutrition.

Symptoms and History

Signs and symptoms that prompt evaluation for long term enteric access include recurrent aspiration pneumonia, persistent vomiting, and poor growth from inadequate nutrition.


A combination of history and clinical findings is suggestive of the need for long term enteric access. Imaging studies (nuclear medicine gastric emptying study) also play a key role in the diagnosis of gastroparesis.


Initial treatment may be simple placement of a tube that goes through the nose to reach the stomach (nasogastric) or small bowel (nasojejunal). These can be used for nutrition as well as to aid in diagnosis. When long term enteric access is needed a gastrostomy tube (G tube) or gastrojejunostomy tube (GJ tube) can be placed.