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Types of feeding tubes

Types of Feeding Tubes: A Complete Guide to G-Tubes, J-Tubes, GJ-Tubes, NG-Tubes, and Low-Profile Buttons

Types of Feeding Tubes for Home Enteral Nutrition

When a patient — pediatric or adult — needs nutritional support that bypasses the mouth, several different types of feeding tubes are available. The right tube for a given patient depends on how long the tube is needed, where in the digestive tract it should empty, the patient's anatomy, and how the patient or family will manage care at home.

This guide covers every feeding tube type used in modern home enteral nutrition: nasal tubes (NG, NJ), surgically placed gastrostomy tubes (G-tubes, including PEG and balloon button styles), jejunostomy tubes (J-tubes), and combination gastrojejunal tubes (GJ-tubes). For each type, we cover what it is, who needs it, how long it stays in, and what daily home care looks like.

According to the Oley Foundation — the leading nonprofit serving the home enteral and parenteral nutrition community — nearly half a million children and adults in the United States use a feeding tube. The variety of tube types reflects the variety of underlying medical needs they serve.

Two Big Categories: Where the Tube Empties

The first decision in tube selection is anatomic: where does the tube need to deliver nutrition?

Feeding Into the Stomach

Tubes that empty into the stomach — NG tubes and G-tubes (including PEG tubes) — work for patients with normal or near-normal stomach function.

The stomach handles bolus volumes, controls release into the intestines, and tolerates a wide range of formula types. Most patients who can tolerate gastric feeding are fed this way.

Feeding Into the Small Intestine

Tubes that empty into the small intestine — NJ tubes, J-tubes, and the jejunal port of GJ-tubes — bypass the stomach and deliver nutrition directly to the jejunum.

These are used when the stomach can't safely or effectively handle feedings, such as in severe reflux, gastroparesis, recurrent aspiration, post-surgical anatomy, or pancreatic disease.

Jejunal feeds must be continuous (slow drip), as the small intestine cannot safely handle bolus volumes.

This distinction shapes everything else about tube management — including feeding method, rate, medication delivery, and how the tube is replaced.

Short-Term Tubes Through the Nose: NG and NJ

Nasal Feeding Tubes (Short-Term Use)

Nasal tubes are typically chosen when feeding support is expected to be temporary — generally six weeks or less, though some pediatric patients may use fine-bore nasal tubes for longer.

Nasogastric Tube (NG-tube)

A thin, flexible tube made of polyurethane or silicone, passed through the nose, down the esophagus, and into the stomach. It is commonly used for short-term feeding, as a bridge to surgical tube placement, or in pediatric cases where a non-surgical approach is preferred.

Nasojejunal Tube (NJ-tube)

Similar in placement to an NG-tube, but extends beyond the stomach into the jejunum. It is used when short-term jejunal feeding is required, or when a patient is not a candidate for immediate surgical placement.

What home care looks like for nasal tubes:

  • Tape securement at the nose checked daily
  • Verification of position before each feed (pH check or length marking)
  • Replacement every 4–6 weeks (or per protocol)
  • Visible and more noticeable than surgical tubes
  • Higher risk of dislodgement (coughing, vomiting, accidental pulling)

Nasal tubes are typically replaced by trained clinicians, though some pediatric programs train caregivers to replace fine-bore NG tubes at home in selected long-term cases.

Long-Term Gastrostomy Tubes: PEG and G-Tubes

Gastrostomy Tubes (Long-Term Feeding)

When a feeding tube is needed for more than 4–6 weeks, placement through the abdominal wall into the stomach becomes the standard approach.

PEG Tube (Percutaneous Endoscopic Gastrostomy)

Placed using an endoscope passed through the mouth into the stomach, the PEG tube is inserted through the abdominal wall. It includes an internal bumper that secures it inside the stomach, an external disc resting on the skin, and a tube extending outside the body.

PEG is often the first long-term feeding tube because the procedure is quick, widely available, and commonly performed by gastroenterologists.

Surgical Gastrostomy (G-tube)

Placed through a surgical incision in the abdomen, using open, laparoscopic, or assisted techniques. This method is used when PEG placement is not feasible due to anatomical factors, prior surgeries, or inability to tolerate endoscopy.

Long-Tube Style

A longer tube extends outside the body and is typically secured with an external bumper. Common in initial placements and widely used in adults.

Low-Profile Button

A shorter device that sits flush against the skin. Feeding extensions are connected only during use, making it more discreet and easier to manage, especially for active patients.

Most pediatric patients transition from a long-tube PEG to a low-profile button at the first scheduled change (typically 6–12 weeks after placement), once the stoma tract has matured. Adults may continue with long-tube styles, though button conversion is becoming more common.

Low-Profile Balloon Button G-Tubes

Low-profile balloon buttons are the most common long-term home G-tube for pediatric patients and a growing share of adult patients. Major brands include:

  • MIC-KEY (Avanos / Halyard) — the most widely used pediatric button worldwide
  • AMT Mini ONE (Applied Medical Technology) — popular alternative with a similar design
  • Bard Button
  • Nutriport

All of these tubes share a common design: a low-profile external bolster sits flush with the skin, while a balloon inside the stomach (filled with sterile water, typically about 5 mL) holds the tube in place. A removable extension set is connected only when feeds or medications are given.

Inconspicuous under clothing
Lower profile during play, bathing, and sleeping
Reduced risk of accidental pulling
Easier at-home replacement with training
Widely familiar to families and suppliers
Balloon button tubes are typically replaced every 3–6 months at home by trained caregivers or home health nurses. For more on timing and technique, refer to your detailed feeding tube replacement at home.

Jejunostomy Tubes (J-Tubes)

A jejunostomy tube delivers nutrition directly into the jejunum, bypassing the stomach entirely. J-tubes are used when gastric feeding is not safe or effective.

Indications for J-tube Placement

  • Severe, persistent gastroesophageal reflux unresponsive to medical management
  • Severe gastroparesis (delayed stomach emptying)
  • Recurrent aspiration despite gastric feeding
  • Post-surgical anatomy that prevents gastric feeding
  • Pancreatic disease where gastric feeding worsens symptoms

Placement Methods

  • Surgical jejunostomy (most common for long-term use)
  • Percutaneous endoscopic jejunostomy (PEJ)
  • Conversion from a GJ-tube once feeding tolerance is established

Important Home Care Differences for J-tubes:

  • Feeds must be continuous (pump-delivered, slow drip)
  • More aggressive flushing protocols due to smaller tube size and clog risk
  • Tube replacement is done in clinic or interventional radiology — not at home
  • Many medications cannot be given via J-tube; pharmacist guidance is required

Gastrojejunal Tubes (GJ-Tubes)

A GJ-tube is a hybrid device with two separate ports — a gastric (G) port that opens into the stomach, and a jejunal (J) port that extends through the stomach into the jejunum.

Device Features

  • Jejunal port for J-feedings, flushes, and medications
  • Gastric port for venting, gastric medications, or eventual return to gastric feeding
  • Balloon port (BAL) used to inflate the internal retention balloon

Why a Patient Might Have a GJ-Tube

  • Transitioning out of severe gastric intolerance while maintaining nutrition
  • Need for dual access — medications via stomach, feeds via jejunum
  • Bridge to permanent J-tube placement if long-term jejunal feeding is needed

Critical Home Care Notes for GJ-tubes:

  • Do not rotate the tube — rotation can cause jejunal migration back into the stomach
  • Tube replacement is done in interventional radiology, not at home
  • Typical replacement interval is every 3–4 months
  • If dislodged, place a same-size G-tube balloon immediately to maintain the tract until replacement

Information Gain: How Tube Choice Affects Daily Family Life

Most generic tube comparison articles list features. What actually matters to families is how each tube changes daily life.

Bathing & Water Exposure

Long-tube PEGs can be awkward in the bath and often need to be taped to avoid catching. Low-profile buttons sit flush against the skin and are easier to manage. Swimming requires physician approval and waterproof protection for any abdominal tube.

Clothing

Long-tube PEGs require clothing that accommodates the external tube. Low-profile buttons are discreet under regular clothing, which can significantly impact confidence and comfort.

Play & Physical Activity

Low-profile buttons support active movement and play. Long-tube styles are more prone to catching, pulling, or dislodgement during activity or sleep.

Travel & Social Life

Button tubes allow patients to disconnect extensions when not feeding, making the tube nearly invisible. Long-tube styles remain visible at all times.

Caregiver Workload

Daily care varies by tube type. Buttons generally require less maintenance once healed. Long-tube PEGs need more securement, while NG tubes involve frequent replacement and monitoring.

Long-Term Cost

Button tubes require replacement every 3–6 months (typically covered with authorization). PEG tubes last longer but need clinic replacement. NG tubes are inexpensive but require repeated replacement effort.

These real-world factors are why pediatric programs often transition patients from PEG tubes to low-profile buttons once the stoma matures (usually 6–12 weeks). While medical function may be similar, the impact on daily life is significantly different.
Managing tube feeding at home for a child or adult loved one?
Focus Family Care provides Medicare-certified home nursing for tube-fed pediatric, young adult, and adult patients across Miami-Dade, Broward, Palm Beach, St. Lucie, Martin, Indian River, and Okeechobee counties. Our nurses are trained on every major tube type covered in this guide.
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Comparison Table: Quick Reference
Tube Type Where It Empties Typical Use Length Placement Method Caregiver-Replaceable?
NG (Nasogastric) Stomach Days to ~6 weeks Bedside (clinical staff) Selected pediatric cases with training
NJ (Nasojejunal) Jejunum (small intestine) Short-term, weeks Bedside under fluoroscopy No
PEG (long tube) Stomach 1–2+ years Endoscopic (GI team) No — clinic only
Surgical G-tube (long tube) Stomach 1–2+ years OR / surgical No — clinic only
Low-profile balloon button (MIC-KEY, AMT Mini ONE) Stomach 3–6 months per device Replaced from existing PEG/G site Yes, with training, mature stoma
GJ-tube (gastrojejunal) Stomach + jejunum (dual port) 3–4 months per device Interventional radiology No
J-tube (jejunostomy) Jejunum Long-term Surgical or endoscopic No

Choosing the Right Tube: Who Decides

The tube selection decision is made by the medical team — typically the gastroenterologist, surgeon, or pulmonologist working with the registered dietitian and the family. Factors include:

Anticipated duration of need (days, weeks, months, years)

GI function (does the stomach work? Is reflux severe? Does the patient aspirate?)

Patient anatomy (any surgical history affecting placement options)

Underlying disease and prognosis

Family caregiver capacity

Insurance coverage and DME availability

Patient/family preferences (where appropriate)

Families should not face this decision alone. A clinic visit with the tube-placing physician, the dietitian, and ideally a tube-feeding family who has been through a similar decision can be invaluable.

Tube Sizing: French and Length

Two measurements describe every tube:

French (Fr) size — the outer diameter of the tube. Common sizes: 12 Fr, 14 Fr, 16 Fr, 18 Fr, 20 Fr, 22 Fr, 24 Fr. Larger French = larger inner diameter = less clog risk. Smaller French = more comfortable but more clog-prone.

Length — for low-profile buttons, the distance between the abdominal wall and the inside of the stomach. Common lengths: 0.8 cm, 1.0 cm, 1.2 cm, 1.5 cm, 1.7 cm, 2.0 cm, 2.5 cm, 3.0 cm, 3.5 cm, 4.0 cm. The right length depends on the patient's abdominal wall thickness — a stoma length measuring tool is used at first replacement to confirm correct sizing.

A tube too short can become buried in the stomach wall (buried bumper syndrome). A tube too long sits loosely and can leak. Both warrant replacement with the correct size.

Cost and Insurance Coverage

Medicare Part B covers medically necessary feeding tubes and supplies under DME benefits for qualifying patients (permanent functional impairment of the GI tract)

Florida Medicaid MMA plans cover tubes and supplies under DME with prior authorization

Private insurance varies — confirm DME benefit, deductible, and any specific brand or supplier requirements

Self-pay reference cost: a low-profile balloon button typically runs $150–$300+ per unit. Insurance authorization is critical for sustainable home enteral nutrition

Frequently Asked Questions

Q: What's the difference between a PEG tube and a G-tube?

A: PEG (percutaneous endoscopic gastrostomy) refers to the placement procedure — the tube goes in via endoscope. G-tube (gastrostomy tube) is the broader category for any tube that goes through the abdominal wall into the stomach. A PEG tube is a type of G-tube. Many G-tubes are placed surgically rather than endoscopically — those aren't PEG tubes specifically, but they are G-tubes.

Q: What's a MIC-KEY button?

A: MIC-KEY is the most widely used brand of low-profile balloon gastrostomy button. It sits flush with the skin, has a small water-filled balloon inside the stomach to hold it in place, and connects to a removable extension set when feeds or medications are given. AMT Mini ONE is a similar competing brand.

Q: Why is my child's feeding tube called both a button and a G-tube?

A: A "button" describes the low-profile, skin-level shape of the device. "G-tube" describes its function and placement (gastrostomy — opening into the stomach). A low-profile balloon button is one type of G-tube. Both terms refer to the same device for most pediatric patients.

Q: Can a feeding tube be removed once it's not needed anymore?

A: Yes. When a patient no longer needs tube feeding, the tube is removed and the stoma typically closes on its own within days to weeks. For long-established stomas (years), surgical closure is sometimes needed. Most short- to medium-term tube users (months to a few years) experience spontaneous stoma closure.

Q: Is a J-tube better than a G-tube?

A: Neither is "better" — they serve different needs. G-tubes feed the stomach; J-tubes bypass the stomach to feed directly into the jejunum. A G-tube is the right choice when stomach function is intact. A J-tube is indicated when stomach feeding isn't safe or effective due to severe reflux, gastroparesis, or recurrent aspiration.

Q: How often does a feeding tube need to be replaced?

A: Depends on tube type. Low-profile balloon buttons: every 3–6 months. PEG tubes: every 1–2 years (clinic-based). NG tubes: every 4–6 weeks. GJ-tubes: every 3–4 months in interventional radiology. J-tubes: variable, typically annually or as needed. See our companion guide on feeding tube replacement at home .

Q: My child's tube has multiple ports — what are they for?

A: For a GJ-tube: jejunal port (J) for feeds and medications into the small intestine, gastric port (G) for stomach venting or gastric medications, and balloon port (BAL) for the internal water balloon. For a single-port G-tube button: just the feeding port and the balloon port.

Q: Can I shower with a feeding tube?

A: Yes — most patients with mature stomas can shower normally. Bathing in a tub is also generally fine. Swimming requires physician approval and typically waterproof barrier dressings. Avoid direct strong water pressure on the stoma.

Q: What if my feeding tube gets clogged?

A: Try a warm water flush first (30 mL, slow gentle pressure). If it doesn't clear, follow your physician's order for an enzymatic declogger (typically pancreatic enzyme + sodium bicarbonate, prescribed for this purpose). Never force fluid through a clogged tube — pressure can damage the tube or stoma.

Focus Family Care provides Medicare-certified home health nursing for tube-fed patients of all ages across South Florida. Pediatric, adult, and senior patients with G-tubes, J-tubes, GJ-tubes, NG-tubes, and low-profile buttons. Medicare, Florida Medicaid, iBudget, and most private insurance plans accepted.
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