Introduction Patients with disorders of gut–brain interaction (DGBI) and gastrointestinal dysmotility (GID) frequently experience severe nutritional compromise requiring enteral support. Jejunal feeding is often considered in patients unable to maintain adequate oral intake, particularly when gastric feeding intolerance or severe dysmotility exists.
Introduction
Patients with disorders of gut–brain interaction (DGBI) and gastrointestinal dysmotility (GID) frequently experience severe nutritional compromise requiring enteral support. Jejunal feeding is often considered in patients unable to maintain adequate oral intake, particularly when gastric feeding intolerance or severe dysmotility exists. However, clinical practice in this area remains highly variable and evidence guiding management is limited.
Problem Statement
The experiences, confidence levels and perceptions of healthcare professionals managing jejunal feeding in DGBI and GID are poorly understood. Limited specialist neurogastroenterology access and uncertainty regarding feeding tolerance may contribute to inconsistent care pathways and suboptimal nutritional management.
Summary
This survey-based study evaluated healthcare professionals’ perceptions regarding jejunal feeding in patients with DGBI and gastrointestinal dysmotility. Most respondents were dietitians and physicians actively involved in nutritional support, although a striking majority reported limited access to specialist neurogastroenterology services. Clinicians perceived jejunal feeding to be more commonly required in severe gastrointestinal dysmotility disorders than in DGBI, reflecting the greater burden of objective motility impairment in GID. Interestingly, despite DGBI generally being considered less structurally severe conditions, respondents reported lower confidence managing these patients compared with those with GID. This likely reflects the complex overlap of visceral hypersensitivity, symptom amplification, psychosocial comorbidity and uncertainty surrounding pathophysiology in DGBI populations. Tolerance to jejunal feeding was also perceived to be poorer in DGBI compared with GID, with most clinicians reporting inability of patients to tolerate infusion rates above 50 mL/hour. Another important finding was the extremely high prevalence of opioid exposure across both groups, highlighting the growing concern regarding opioid-associated gut dysfunction and worsening dysmotility in these patients. The study emphasizes substantial gaps in specialist service provision and underscores the need for multidisciplinary neurogastroenterology-led nutritional pathways. It also highlights the importance of individualized feeding strategies, cautious opioid stewardship and further prospective research to optimize jejunal feeding protocols in complex DGBI and dysmotility populations.
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