G/GJ tubes: Common skin problems related to feeding tubes

​​Despite your best efforts to keep your child’s stoma and the skin around it dry and clean, you may encounter some skin problems with your child’s G tube or GJ tube.

Red skin

Your child’s skin may get sore and red because of the following:

  • A sensitivity or allergy to the tape that holds the G tube or GJ tube to the skin of the stomach.
  • Acidic stomach contents leaking onto your child’s skin around the feeding tube.
  • The G tube or GJ tube moving around too much in the stoma.
  • Infection.

How to protect your child’s skin:

  • Change the tape holding the feeding tube to the skin of the stomach daily. (The tube should always be taped down to prevent it from being accidentally pulled out.)
  • Use a barrier tape (available at your local pharmacy). This is a layer of moisture-resistant, flexible tape that stays on your child’s skin for up to one week. Stick the original tape that may be causing the sensitivity on top of the barrier tape to prevent it from hurting your child’s skin.
  • Use unscented skin care and laundry products geared toward sensitive skin. Look out for changes to your child’s skin if you change products.
  • If you have trouble taking the tape off your child’s skin, put a wet face cloth over the tape for a few minutes before removing it or use adhesive-remover products (available at your local pharmacy).

Leaking

Leaking from the stoma is not typical. If your child has a cold or another infection, their stoma may look redder or may leak more than usual. This should get better once your child is feeling better. Leaking can also be caused by conditions that increase pressure in the stomach, such as constipation, gas, and chronic coughing or vomiting. If your child experiences leaking and has one or more of these issues, speak to your medical team.

How to prevent your child’s stoma from leaking:

  • If your child has a G tube that has a balloon on the end, make sure that the balloon is filled properly and that the tube does not move too much in and out of the stoma.
  • If the liquid leaking from your child’s G tube or GJ tube makes the skin burn or feel itchy, protect the skin with a barrier cream. Creams that are zinc-based work best, and are available at your local drugstore. Apply the barrier cream around the stoma to protect the skin.
  • If your child’s tube has an adjustable plastic disk on the outside that keeps the feeding tube in place, make sure it is not touching your child’s skin.
  • Make sure your child’s feeding tube is always taped to your child’s skin to stop the tube from moving around too much.

If your child’s leakage does not stop or gets worse, contact your medical team or your G tube specialist.

Infection

Your child may have a stoma infection if you see any of these signs:

  • More redness of the skin around the feeding tube than usual.
  • A change in the colour and the thickness of the drainage leaking around the feeding tube. Yellow-green sticky drainage from the stoma is normal. This drainage may crust around the stoma and tube, and can be washed off daily with soap and water.
  • Swelling and/or a feeling of warmth around your child’s feeding tube.
  • Pain and/or fever.

For mild infections with a small increase in redness and discharge, you may apply an over-the-counter antibiotic ointment or cream, such as Polysporin™, to the stoma.

If your child has any of these signs, contact your family doctor or pediatrician to look at the stoma and potentially prescribe stronger antibiotics.

Granulation tissue

The extra tissue that grows around the feeding tube is called granulation tissue. It can look dark pink and may bleed easily. Some reasons granulation tissue can form are:

  • the feeding tube moves too much in the stoma
  • the stoma is wet or covered with a dressing
  • there is too much pressure on the stoma
  • there has been trauma to the stoma.

How to prevent granulation tissue:

  • Always tape the feeding tube to the skin on your child’s stomach.
  • Make sure your child’s balloon-type G tube fits properly. If you think your child’s balloon-  type tube is too loose or too tight, contact your G tube specialist to re-measure the size of the tube.
  • Do not put dressings on the stoma unless advised to do so by your medical team.
  • Keep the stoma open and dry. Do not apply ointments or creams unless advised to do so by your medical team.

Treatment

Preventive strategies, outlined above, are the best way to avoid common skin problems. However, when they do occur, you can try treating them at home. For example, if your child has redness or granulation tissue around the stoma, you can apply hypertonic salt soaks​ to help dry out and soothe the area around the feeding tube. You can also apply silver nitrate to the stoma if you have been trained to do so. Contact your G tube specialist if you are concerned about your child’s stoma or the skin around the tube.

Key points

  • Acidic stomach contents that leak onto your child’s skin can cause redness and irritation.
  • Use barrier tapes or barrier creams to protect your child’s skin.
  • Always tape your child’s tube to the skin and change the tape daily.
  • Signs of infection include more redness than usual, a change in colour or thickness of the stoma drainage, pain, swelling, a warm feeling around the tube, and fever.
  • Granulation tissue can be caused by increased movement of the tube, a wet or covered stoma, trauma, and too much pressure on the stoma.
  • Keep your child’s stoma open and dry.
  • If your child’s skin becomes red and irritated, try hypertonic salt soaks.

​​Holly Norgrove, RN, BScN

9/7/2015


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