Indications for jejunostomy tube placement in a patient with diabetic gastroparesis:
(1) severe gastroparesis
(2) unintentional weight loss >= 10% of the usual body weight over a period of 3-6 months
(3) failure of oral route alone to deliver sufficient caloric intake
(4) repeated hospitalization for refractory symptoms or acute exacerbations
(5) impaired delivery of oral medications
(6) need for nasogastric intubation to relieve symptoms of gastric distention
(7) poor quality of life secondary to nausea and vomiting
If the only indication is nasogastric intubation to relieve symptoms of gastric distention, then a gastrostomy tube may provide sufficient relief.
Severe gastroparesis by itself is not an indication for jejunostomy tube placement.
Contraindications:
(1) failure to obtain informed consent
(2) nonfunctioning gastrointestinal tract
