A 75-year-old male with aspiration pneumonia on continuous enteral nutrition via NG tube, unsafe for oral diet. Which long-term feeding option would be most appropriate?

• A. Central PN
• B. PEG feeding
• C. PEJ feeding
• D. Peripheral PN

Answer: (C)

When aspiration risk is high, delivering nutrition past the stomach reduces the chance of reflux and inhalation during feeds. Placing a feeding tube into the jejunum (PEJ) achieves post-pyloric access, bypassing the stomach entirely. This makes long-term enteral feeding safer for someone who has aspiration pneumonia and cannot take food by mouth.

Enteral feeding via the jejunum is preferred over parenteral nutrition when the GI tract is usable, because it maintains gut integrity and has fewer infections and metabolic complications. A PEG would feed into the stomach and preserve the risk of aspiration, while central or peripheral parenteral nutrition bypasses the gut altogether and carries its own risks; they’re less favorable when post-pyloric enteral feeding is feasible.

So, using a jejunostomy feeding tube placed percutaneously under endoscopic guidance provides the safest long-term feeding approach in this scenario.