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Gastrostomy Tube: Common Problems

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This brochure gives answers to common problems you may encounter while caring for your child and their gastrostomy tube (G-tube).

What to do if your child’s G-tube moves

If the tube looks longer or shorter, it may have moved out of position. If the tube has moved into the stomach, your child may start throwing up or have watery bowel movements. If any of these signs occurs, contact your nurse or family doctor.

To prevent your child’s G-tube from moving:

  • Always tape the tube securely in place.
  • Marking G-tube
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  • Mark the outside part of your child’s feeding tube where it meets your child’s stomach. Use a marker with ink that does not wash off. Or measure the length of the outside part of your child’s feeding tube. Make sure to mark this number down somewhere.
  • If your child’s feeding tube has a balloon at the end of it, check the amount of water in the balloon once a week. There should be 3 mL or 5 mL of water in the balloon. Use a syringe to fill the balloon with water up to the mark that says 5 mL.  

What to do if your child’s feeding tube falls out or gets pulled out

In your supplies you will have a soft tube called a Foley catheter. It will be one size smaller than your child’s G-tube. Try to put the Foley catheter into the hole (opening) following the directions below. The sooner you try to put the Foley catheter into the hole the easier it will be. Remember, the longer the tube is out, the smaller the hole will become.

If you cannot put the tube in, call the G-tube nurse. Go to the emergency department on holidays, weekends or at night. 

Putting your child’s feeding tube back in

If your child’s feeding tube falls out, try to keep the hole in your child’s stomach open until a new feeding tube can be put in. The first 6 weeks after your child first gets her feeding tube is the most important time for healing.

If your child’s G-tube or GJ-tube falls out within 8 weeks of when it was put in:

You will need:

Foley Catheter
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  • tape
  • Foley catheter
  1. Wash your hands and the skin around your child’s feeding tube gently but thoroughly with soap and water.
  2. Wet the tip of the catheter with lubricating jelly such as KyJelly™ or Muko™. DO NOT use Vaseline.
  3. Put the tip of the Foley catheter about 2 or 3 inches, or 4 to 6 centimetres into the hole in your child’s stomach where the feeding tube was. Measure the tube against your index finger.
  4. Tape the Foley catheter to your child’s stomach.
  5. Do not use the Foley catheter to give your child any food or medicine. If your child cannot eat or drink by mouth, contact the emergency department as soon as possible.

If your child’s G-tube or GJ-tube falls out after she has had it for longer than 8 weeks, follow these steps:

  1. Do not go to the emergency room.
  2. Gather up some tape and a small thin Foley catheter or a G-tube.
  3. Wash your hands and the skin around your child’s feeding tube gently but thoroughly with soap and water.
  4. Put water on the tip of the Foley catheter or G-tube. Or use a jelly that mixes with water, called a water-soluble lubricant, such as Muko™ or KY Jelly™.
  5. Put the tip of the Foley catheter or G-tube about 2 inches or 3 inches, or 4 centimetres to 6 centimetres, into the hole in your child’s stomach where the feeding tube was.
  6. Tape the Foley catheter or G-tube to your child’s stomach.
  7. After putting in the Foley catheter or G-tube, fill the balloon with 5 mL of water with a syringe. Pull back on the feeding tube until you feel it stop on the inside of the stomach. Tape it to your child’s skin.
  8. To check if the G-tube is in the right place, connect a syringe to the end of the tube. Pull the plunger of the syringe back to take some liquid from the stomach.

After you see the liquid from the stomach, close the G-tube with the plug connected to the tube. Do not use the G-tube until you know that it is in the right place.

If you cannot get liquid from the stomach, you must call your G-tube nurse for more instructions.

When to seek medical help

Go to the emergency department if your child has any of the following problems after the Foley catheter is inserted:

  • a hard bloated stomach
  • severe pain in the stomach 
  • throwing up or gagging
  • sudden high fever
  • diarrhea

Stop feeding your child and call your local emergency department if your child has any of the following problems while feeding:

  • problems with food and liquids getting into the lungs (aspiration)
  • coughing
  • throwing up or gagging
  • problems breathing
  • a hard bloated stomach
  • severe pain in the stomach
  • a sudden high fever
  • throwing up or gagging
  • diarrhea

Getting a new feeding tube for your child

For a new G-tube, call the G-tube nurse and leave a message so they can arrange one for your child. The nurse will call you the next working day.

What to do if your child’s feeding tube gets blocked

To unblock your child’s feeding tube, you will need:

  • 1-mL, 3-mL, and 5-mL syringes
  • warm water
  1. Fill a 1-mL, 3-mL, or 5-mL syringe with warm water.
  2. Connect the syringe to the end of the feeding tube.
  3. Push and pull on the plunger of the syringe to move the liquid in and out of the feeding tube. That will help clear out any formula that is left in the tube. You may have to try this a few times before the feeding tube is no longer blocked.
  4. When the feeding tube is no longer blocked, fill the syringe with 10 mL of water and push it into the feeding tube.
  5. Take the syringe off the feeding tube and close it up.

If the tube is still hard to flush:

  1. Put 5 mL to 10 mL of pop, pulp-free orange juice, or cranberry juice into the tube.
  2. Let it stand for 5 to 10 minutes.
  3. Flush the tube with 10 mL of water.

If you cannot unblock your child’s feeding tube and you have learned how to change it, you may change the feeding tube now. If your child has a GJ-tube that you cannot clean with this method, call the G-tube nurse for help.

You can prevent your child’s feeding tube from getting blocked with formula or medicine by keeping the inside clean.

  • Flush the feeding tube with 5 mL to 10 mL of water after every feeding.
  • Clean the feeding tube well after giving your child medicine through this tube.

The G-tube may cause skin problems

Red skin

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

  • an allergy to the tape which holds the feeding tube to the skin of the stomach
  • harsh juices from the stomach leaking out around the feeding tube
  • the feeding tube moving around too much in its hole
  • infection

Infection

Your child may have an 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 thickness of the liquid leaking around the feeding tube
  • pain or swelling, or a feeling of warmth around your child’s feeding tube
  • a fever

If your child has any of these signs, call your family doctor or paediatrician.

How can you treat problems with your child’s skin?

If your child has problems with the skin, you can use a warm salt water soak to dry out and soothe the area around the feeding tube. Soak the skin with salt water 3 times a day, every day that your child has a skin problem.

To make a salt water soak:

  1. Measure out 1 cup of warm water and 2 teaspoons of table salt.
  2. Stir the salt into the warm water until the salt disappears.
  3. Wet a piece of gauze or a strip of clean cotton face cloth in the warm salt water.
  4. Place the wet gauze or cotton cloth around the feeding tube on the skin of your child’s stomach. Leave for 5 minutes.

Your child needs a salt water soak 3 to 4 times every day. Reduce how often you give your child a salt soak as their skin heals.

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 you take it off.

How can you protect your child’s skin?

  • If liquid leaking around your child’s feeding tube makes the skin burn and feel itchy, protect the skin with a cream called a barrier cream. Zincofax™ and Ihles Paste are barrier creams that you can buy in your local drugstore. If your child’s feeding tube leaks, please call your G-tube nurse
  • If your child’s feeding tube has a balloon on the end, make sure that the balloon is filled properly.
  • Make sure the plastic circle that looks like a disc and holds the feeding tube in place is not touching your child’s skin.
  • Make sure your child’s feeding tube is taped to the skin of your child’s stomach to stop the tube moving around.

Granulation tissue

The extra skin tissue that grows around the feeding tube is called granulation tissue. The extra tissue looks dark pink and may bleed easily.

If the extra tissue gets red, swollen, and tender, or keeps growing, the nurse at the G-tube clinic or your child’s doctor can treat it.

To stop granulation tissue from forming, make sure you keep your child’s feeding tube taped down so that it does not move. The feeding tube rubbing on the skin can cause extra tissue to grow. Do not apply any creams directly to the hole.

For more information, please see Gastrostomy Tube: Caring for Your Child and Their G-Tube and Gastrostomy Tube: Changing Your Child’s Dressing.

 Key points

  • Make sure you keep your child's G-tube securely taped in place.
  • Do not apply creams directly to the hole.
  • If the G-tube has moved into the stomach, your child may start throwing up or have watery bowel movements. If any of these signs occurs, contact your nurse or family doctor.
  • If the G-tube falls out, place the Foley catheter into the hole as soon as you can.
  • Place a salt-soak on your child's skin to treat redness or infection.
  • If the granulation tissue gets red, swollen, and tender, or keeps growing, the nurse at the G-tube clinic or your child’s doctor can treat it.

Julia Kelly, RN

3/29/2011




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