Overall rates of tube dysfunction have been re­ported as high as 45 % in a mixed series of gas­trostomy and jejunostomy tubes. These compli­cations—clogging, knotting of the tube [53], dis­lodgement, or breakage of the connectors—may be considered minor; however, they may lead to the interruption of nutrition delivery or addi­tional invasive procedures. Clogging of the tube is a very common problem, reported in 0.5–6 % of prospectively collected series of patients un­dergoing a Witzel jejunostomy tube at the time of esophagectomy or gastric surgery [41, 54]. Needle catheter jejunostomy has been reported to have similar propensity for clogging as Witzel jejunostomy [55]. Best practices for feeding tube maintenance include adherence to a flushing reg­imen and avoidance of introducing any solid ma­terial into the tube (e.g., crushed pills). In addi­tion, checking of residuals via a jejunostomy tube is not recommended, both due to technical limita­tions and inaccuracy of the measurement and due to concerns that this might hasten clogging. Meat tenderizer, pancreatic enzymes, and soda have all been utilized to help dissolve the inspissated tube feed substance from clogged jejunostomy tubes [56]. Of these agents, pancreatic enzyme appears to have the greatest efficacy in resolving the ob­struction, with 96 one series [57]. Some researchers have suggested that a pancreatic enzyme “lock” similar to a hep­arin lock for vascular catheters may be utilized as prophylaxis against inspissated tube feeds ob­structing the feeding tube [58]. The mechanical remedy for a clogged tube is steady or oscillating pressure via a syringe filled with saline or water. Reconstitution of patency has also been achieved with a vascular embolectomy catheter [59]. Of note, in the series quoted above with a 6 dence of tube obstruction, all feeding tubes were able to be out need for replacement of the tube [41].