I am a 26 year old female, now 5 days removed from an endoscopic g-j tube replacement (Mickey Button). I am experiencing continuous pain that increases significantly with administration of tube feeds, (even at very low feed rates 10ml/hour). This is the fourth time I have had my g-J tube replaced. Each time with a mickey button. The initial placement and subsequent replacements were done by interventional radiology. I never had any problems increasing feed rate or tolerating continuous feeding after these tube replacements. Feedings have always been relatively painless until now. I have my G-J tube because I have non-diabetic gastroparesis that often prevents me from taking food or fluids by mouth.

Inexplicably, this time the placing hospital informed me the tube would be placed via endoscopy. While previous tube replacements by IR have taken less than an hour, this last tube replacement via endoscopy took almost 4 hours. I spoke to the surgeon that placed this tube and asked why the procedure took this long. He responded that they anchored the jejunal extension of the tube with an endoclip, and that they "had trouble clipping it."

It has now been 5 days since the initial tube replacement and endoclip placement via endoscopy and I am experiencing lower abdominal pain that increases in proportion to the time feeding lasts and the rate of feeding. I have only been able to tolerate up to 10/ml per hour for 1 hour before stopping and I am left in severe pain. I am on IV Dilaudid 2q3. Clearly, this feed rate is not sufficient to provide anywhere near the nutrients I need. The doctors have verified tube placement via x ray, and do not see any abnormalities in my blood work. I suspect their working theory is that my pain is psychogenic, but they do not communicate with me very well. Their refrain has been that the tube is physically intact and that I will be fine if I taper up my feeding rate and duration. I am of sound mind and I am positive the pain I am experiencing is because something is physically different, not because my mental state has changed (it hasn't). I am unable to tolerate the pain that increased feeding rates and duration causes, so I am starting to get desperate.
My question is this: I have never experienced difficulty tolerating feed due to pain with previous tubes. All of these tubes were replaced via interventional radiology and nothing is different about the circumstances and events surrounding this replacement. So far as I can see, the only difference with this latest tube is that it was placed endoscopically and is anchored with an endoclip. Is there any way the placement method or the inclusion of an endoclip could explain the pain I am experiencing?