Causes for pain in stomach and chest from j tube

Posted by tharris6509 @tharris6509, Oct 4, 2023

My husband was diagnosed with esophageal cancer in Jan 2023. His cancer has spread to the top of his stomach. He has had constant bloating and pain in his stomach and chest. He is on the j tube 22hrs a day. During the 2 hours off the pain subsides. Doctors say that it is normal to have discomfort with tolerating the j tube. We have tried 3 different feed formulas to see if he could tolerate them better. He is not a candidate for radiation. Does anyone know anything that might help with the discomfort?

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Hi,
Is he spitting up any bile? My mom also had bloating and it was a blockage above the J-tube causing bile to collect in the stomach. She got a G-tube put in just for drainage of the bile.

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Idk. - Is switching to a G-tube a possibility? I think some have said that's an easy way to get all the needed nutrition from actual foods (blended).
Dave

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I'm certainly not a J tube feeding expert... as I had mine for 8 months, 4 before my esophagectomy, and 4 after. But this was 3 years ago now, and in general, my feedings went well, although I was a bit of a knucklehead (at first) in understanding the purpose of this tool.

I'll assume his J tube has been properly installed... it has been correctly placed into the jejunum. A simple thing, but I've seen this botched a few times. Then I'll also assume that his problems are of the minor variety (nausea, abdominal cramps, diarrhea, etc)... but still, these are unpleasant. But major complications, like a bowel obstruction, or some infection down there, or the tube has dislodged and is no longer functioning correctly... these must be identified and fixed promptly. I'll also assume it's not leaking all over his stomach area, the stoma site is being cleaned daily, and not much leakage is being seen.

But you're doing what is necessary... trying different feeds (allergic reactions are possible), and I'll assume you've played with the feed rates. I did not do well at 100 ml/hr, but was fine at 75 ml/hr. And is position a factor? Does he notice more discomfort if lying down vs sitting up, or standing while feeding? Have you tried diluting his feeds (I often added about 6 oz of water to my feeds)... this have me added hydration and made clogs less likely. Does he have an elevated temp at all?

Gary

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@edward40

Hi,
Is he spitting up any bile? My mom also had bloating and it was a blockage above the J-tube causing bile to collect in the stomach. She got a G-tube put in just for drainage of the bile.

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No there is bile that leaks out from around the port. He has had to have 5 tubes replaced since January. The formula has been changed 3 times to see if that would help but it doesn’t stop the pain.

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@dave640

Idk. - Is switching to a G-tube a possibility? I think some have said that's an easy way to get all the needed nutrition from actual foods (blended).
Dave

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He has tumors in his stomach so they aren’t able to put one there.

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@mrgvw

I'm certainly not a J tube feeding expert... as I had mine for 8 months, 4 before my esophagectomy, and 4 after. But this was 3 years ago now, and in general, my feedings went well, although I was a bit of a knucklehead (at first) in understanding the purpose of this tool.

I'll assume his J tube has been properly installed... it has been correctly placed into the jejunum. A simple thing, but I've seen this botched a few times. Then I'll also assume that his problems are of the minor variety (nausea, abdominal cramps, diarrhea, etc)... but still, these are unpleasant. But major complications, like a bowel obstruction, or some infection down there, or the tube has dislodged and is no longer functioning correctly... these must be identified and fixed promptly. I'll also assume it's not leaking all over his stomach area, the stoma site is being cleaned daily, and not much leakage is being seen.

But you're doing what is necessary... trying different feeds (allergic reactions are possible), and I'll assume you've played with the feed rates. I did not do well at 100 ml/hr, but was fine at 75 ml/hr. And is position a factor? Does he notice more discomfort if lying down vs sitting up, or standing while feeding? Have you tried diluting his feeds (I often added about 6 oz of water to my feeds)... this have me added hydration and made clogs less likely. Does he have an elevated temp at all?

Gary

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Yes we have adjusted the feed rate several times. The only thing that helps the pain is the 2 hrs the pump is turned off. It is on 22hrs off 2. We have even tried just doing the feeding at a very low rate. Nothing seems to help. The doctors say every time it has been replaced that there are no abscess or problems with the placement.

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@tharris6509

Yes we have adjusted the feed rate several times. The only thing that helps the pain is the 2 hrs the pump is turned off. It is on 22hrs off 2. We have even tried just doing the feeding at a very low rate. Nothing seems to help. The doctors say every time it has been replaced that there are no abscess or problems with the placement.

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@tharris6509, this must be horrible for your husband and hard for you to see him suffer. Has his cancer team found any solutions yet to help with the pain?

A Nurse Specialized in Wound, Ostomy and Continence (NSWOC) is a registered nurse (RN) with advanced and specialized knowledge and clinical skills in wound, ostomy and continence care. Are you working with an ostomy specialist?

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@colleenyoung

@tharris6509, this must be horrible for your husband and hard for you to see him suffer. Has his cancer team found any solutions yet to help with the pain?

A Nurse Specialized in Wound, Ostomy and Continence (NSWOC) is a registered nurse (RN) with advanced and specialized knowledge and clinical skills in wound, ostomy and continence care. Are you working with an ostomy specialist?

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Thank you for the information. I’m sorry to say that he passed away on Sunday. I pray for everyone that has to go through this horrible cancer journey.

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@tharris6509

Thank you for the information. I’m sorry to say that he passed away on Sunday. I pray for everyone that has to go through this horrible cancer journey.

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I'm sorry to hear that you only just lost your husband. I'm sending a gentle virtual embrace.
There's so much to do now isn't there? It's all a bit of a whirlwind of a different kind with crazy emotions woven through the fog. Be kind to yourself. And let others take care of you.

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