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Ferluga ED, Archer KR, Sathe NA, et al. Interventions for Feeding and Nutrition in Cerebral Palsy [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013 Mar. (Comparative Effectiveness Reviews, No. 94.)


Bolus feeding

Method of delivering enteral feedings using a limited amount of nutritional product administered through a tube into the stomach over a span of 15–30 minutes several times per day; not usually recommended for persons with a jejunostomy tube as the intestine cannot hold the same volume that the stomach can.1

Castillo-Morales Device

Oral device including removable plates positioned on the upper jaw and including stimulatory elements to promote normal tongue and lip movements.

Continuous feeding

Method of delivering nourishment that involves the drip of formula by gravity or assisted by a pump in an ongoing manner over a specified number of hours into a gastrostomy, jejunostomy, or gastrojejunal tube.1


Procedure in which an instrument containing a camera is inserted into the gastrointestinal tract to visualize organs. This procedure is one of the methods used in the percutaneous placement of gastrostomy, jejunostomy, or gastrojejunal tubes.1

Enteral feeding tube

Feeding device placed into the stomach or jejunum (middle section of the small intestine) through which formula, fluids, and/or medication are given to a person as an alternative to oral feeding.1

Fundoplication/Nissen Fundoplication

Surgical procedure performed for the management of GERD. During the Nissen fundoplication, the upper part of the stomach is wrapped around the lower esophageal sphincter (the ring of muscle at the bottom of the esophagus that acts like a valve between the esophagus and stomach) to strengthen the sphincter and prevent acid reflux. The Nissen fundoplication may be performed using a laparoscope, an instrument that is inserted through tiny incisions in the abdomen, and uses small instruments to hold a camera to look at the abdomen and pelvis, which is less invasive and promotes faster recovery but requires more technical skill.2,3

Gastroesophageal reflux (GER)

Occurs when stomach contents reflux, or back up, into the esophagus (tube that connects the mouth to the stomach) during or after a meal. GER occurs when the lower esophageal sphincter opens spontaneously, for varying periods of time, or does not close properly and stomach contents rise up into the esophagus. GER is also called acid reflux or acid regurgitation, because digestive juices—called acids—rise up with the food. When refluxed stomach acid touches the lining of the esophagus it may cause a burning sensation in the chest or throat (heartburn or acid indigestion).2

Gastroesophageal reflux disease (GERD)

More serious form of gastroesophageal reflux (GER); when acid reflux occurs, food or fluid may rise into the back of the mouth and could then fall down into the lungs, causing respiratory symptoms. Some degree of GER is considered normal, but persistent reflux that occurs more than twice a week or causes symptoms is considered GERD, and it can eventually lead to more serious health problems.2

Gastrojejunal (G/J-tube)

Type of tube for nutritional support that is inserted into the jejunum (the middle section of the small intestine) through an established gastrostomy. It is also referred to as a G/J-tube or transgastric tube.1 This uses a double lumened tube with 2 ports or openings. The G tube opening empties into the stomach and can be used for medication and the J-(jejunum) tube opening which empties into the small intestine can be used for feedings and water.4


Surgical procedure that creates an artificial opening in the stomach for the insertion of a feeding tube.5

Gastrostomy tube (G-tube) insertion

Placement of a feeding tube through the skin and the stomach wall, directly into the stomach (also called a G-tube). This tube helps with feeding and releases air from the stomach.6

Innsbruck Sensorimotor Activator and Regulator (ISMAR)

Oral appliance designed to provide stability for the jaw to develop lip closure and tongue mobility, improving eating and drinking skills.7

Jejunostomy (J-tube)

Surgically placing a feeding tube through the abdominal wall directly into a part of the small intestine called the jejunum. The feeding tube bypasses the stomach and delivers a special liquid food with nutrients directly into the jejunum.2

Nasogastric tube (NG-tube)

Tube is inserted through the nose or mouth, down the esophagus, and into the stomach.6 Typically used for short term.4

Percutaneous endoscopic gastrostomy (PEG) tube insertion

Gastrostomy tubes can be placed under endoscopic guidance, using a much smaller incision (percutaneous endoscopic gastrostomy tube placement, or PEG). An endoscope is passed into the mouth, down the esophagus, and into the stomach. The surgeon can then see the stomach wall through which the PEG tube will pass. Under direct visualization with the endoscope, a PEG tube passes through the skin of the abdomen, through a very small incision, and into the stomach. A balloon is then blown up on the end of the tube, holding in place. PEG gastrostomy tubes avoid the need for general anesthesia and a large incision.6

Percutaneous endoscopic jejunostomy

A type of J-tube placement for nutritional support that occurs with the aid of endoscopy to visualize the jejunum so that a tube can be threaded through a small opening made in the abdominal wall into the jejunum. It is also known as a PEJ tube.1

Glossary References

State of Connecticut Department of Developmental Services. Nursing protocol #NP 09-2: care of persons with jejunostomy tubes or gastrojejunal tubes. www​​/health/np_09_2_care​_of_persons_with_jejunostomy​_tubes_and_gastroj.pdf.
National Digestive Diseases Information Clearinghouse (NDDIC) Digestive diseases A-Z list of topics and titles. www​.digestive.niddk.nih​.gov/ddiseases/pubs/gerd/index.aspx#5.
Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) J Pediatr Gastroenterol Nutr. 2009;49:498–547. [PubMed: 19745761]
Indiana Family & Social Services Administration Division of Disability & Rehabilitative Services Bureau of Quality Improvement Services. Outreach Services of Indiana fact sheet health & safety aspiration prevention: Feeding tubes and feeding/medication administration options. www​​/aspiration_prevention_9.pdf.
National Institute of Neurological Disorders and Stroke National Institutes of Health. Cerebral palsy: hope through research. www​​/cerebral_palsy​/detail_cerebral_palsy.htm#179233104.
U. S. National Library of Medicine. PubMed health medical encyclopedia. www​
Johnson HM, Reid SM, Hazard CJ, et al. Effectiveness of the Innsbruck Sensorimotor Activator and Regulator in improving saliva control in children with cerebral palsy. Dev Med Child Neurol. 2004 Jan;46(1):39–45. [PubMed: 14974646]
Cover of Interventions for Feeding and Nutrition in Cerebral Palsy
Interventions for Feeding and Nutrition in Cerebral Palsy [Internet].
Comparative Effectiveness Reviews, No. 94.
Ferluga ED, Archer KR, Sathe NA, et al.

AHRQ (US Agency for Healthcare Research and Quality)

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