Learn how to keep your child's stoma healthy, and what to do if the stoma or surrounding area become infected.
Key points
Signs of infection include: redness, foul smelling discharge, green thick or white discharge, swelling around the feeding tube, abscess formation, pinpoint rash, pain and fever.
Always wash your hands before handling the feeding tube and the stoma.
Mild infections may be treated with over-the-counter antibiotics, while a prescription may be needed for more serious infections.
Introduction
What is a G tube
Gastrostomy tubes (G tubes) are feeding devices that provide liquid nutrition, medication and other fluids directly into the stomach. G tubes are placed through a surgical opening in your child's tummy (abdomen) called a stoma. The tunnel from the outside into the stomach is called the tract.
The SickKids G-Tube Feeding Program has developed a one page guide to help you quickly troubleshoot any issues with your child's stoma, including granulation tissue, infection, skin irritation from leakage and stoma issues from a loose tube:
Stoma Issues One Pager
Signs and symptoms
Signs of infection
Abscess
Your child may have a stoma infection if you see any of these signs:
Increased and/or spreading redness of the skin around the feeding tube
Thick green or white
discharge coming from the stoma and around the feeding tube
Foul smelling discharge from the stoma
Swelling around your child’s feeding tube
The skin around your chid's stoma feels warmer than the rest of their skin
Abscess formation (collection of pus under the skin)
Infected stomas can develop hypergranualtion tissue. However, it is important to note that hypergranulation tissue is not the same thing as infection. Not all hypergranulation tissue is infected. When the hypergranulation tissue appears without the above signs of infection, it does not need antibiotic treatment. Learn more about
hypergranulation tissue.
Treatment
Treatment of infection
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 other signs of infection (spreading redness, fever and pain), your child needs to be assessed for a more serious infection. Your child’s health-care provider may need to prescribe a stronger antibiotic.
Prescription antibiotics that are used to treat the most common stoma infections are:
A topical antibiotic such as fusidic acid. This is a cream that you will apply directly to the stoma.
An oral antibiotic such as
cephalexin. This is a medication that your child will take by mouth or through the tube.
If the antibiotics are not working, your child may need to be sent for a swab of the stoma and the antibiotics they are taking may need to change. An
ultrasound may be necessary to diagnose an abscess.
How to keep a healthy stoma
Healthy stoma
To keep your child’s stoma healthy, you should:
Wash the stoma daily with soap and water.
Allow the stoma to be open to the air (do not cover it with a bandage or gauze).
