Version May 2024
| Intervention | Available procedures | Purpose | Advantages | Disadvantages |
| Nasogastric tube | Blind Radiologic (under fluoroscopy) | Decompression Access for feeding or medications | Ease of placement Simple procedure Low cost | Easily displaced/removed Short-term use only Discomfort Source of infection Risk of tube blockage Potentially increased reflux, aspiration of feeds |
| Gastrostomy tube | Surgical Radiologic Percutaneous endoscopic | Decompression Feeding | Superior for decompression Moderate ease of placement Bolus feeding may occasionally be possible by gastrostomy tube alone Potentially long term | Questionable value for nutritional support without jejunal tube placement Source of infection Risk of tube blockage High risk of reflux, aspiration of feeds |
| Jejunostomy tube (direct) | Surgical Radiologic Percutaneous endoscopic | Feeding | Superior for nutritional purposes Potential for long-term use | Source of infection Risk of tube blockage Requires enteral infusion pump for nutrition Does not provide for gastric decompression |
| Jejunostomy tube (trans-gastric) | Radiologic Percutaneous endoscopic | Biluminal enteral tube with separate gastric and jejunal ports | Single tube Single procedure for two tubes Single stoma/abdominal Can accomplish decompression and feedings through different ports of the same tube | Risk of migration of jejunal tube into stomach Reflux of feeds into stomach Source of infection Risk of tube blockage (especially jejunal port) Technically somewhat more difficult to place the jejunal tube |
| Separate gastrostomy and jejunostomy tubes | Radiologic Percutaneous endoscopic | Decompression Feeding | Two separate simultaneously working tubes Decreased risk of reflux, aspiration of feeds Provides gastric decompression | Longer, more difficult procedure Higher cost due to two procedures Higher risk of infection due to two stomas/wounds Risk of tube blockage |
| Gastrojejunostomy with or without percutaneous jejunostomy (open versus laparoscopic) | Surgical | Surgical bypass for decompression and feeding | Drainage by gravity Potentially permanent Most useful in gastric outlet obstruction syndrome | Increased morbidity of surgery Needs careful patient selection Gastroparesis, if significant, may not be alleviated and may require jejunal tube placement regardless Higher cost of procedure High expertise required for the procedure |
| Gastric electrical stimulation | Surgical | Feeding Enteral passage of secretions | Physiologic Potentially eliminates the need for enteral feeding No foreign body on body surface (tubes) Decreased risk of infection | More expertise required Cost of procedure and device Unknown benefit for MG (currently, gastric electric stimulation is not used in MG and is still controversial in gastroparesis. Patients are required to have a life expectancy of >6 years). |
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