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G/GJ tubes: Balloon G tubesGG/GJ tubes: Balloon G tubesG/GJ tubes: Balloon G tubesEnglishGastrointestinal;OtherChild (0-12 years);Teen (13-18 years)Abdomen;StomachDigestive systemNon-drug treatmentAdult (19+) CaregiversNA2018-10-25T04:00:00ZHolly Norgrove, RN, BScN7.1000000000000073.60000000000002861.00000000000Health (A-Z) - ProcedureHealth A-Z<p>A balloon G tube is a type of feeding tube that has a balloon on the end to help prevent the tube from being accidentally pulled out. Learn how to care for your child’s balloon G tube and change it at home. </p><p>Gastrostomy tubes (G tubes) are feeding devices that provide liquid nutrition, medications 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.</p><p>Balloon G tubes have a balloon on the end inside the stomach to keep the tube in place. These tubes may be non low-profile or low-profile.</p><h2>Key points </h2><ul><li>A balloon G tube is a type of feeding tube that has a balloon on the end inside the stomach to prevent it from being pulled out. </li><li>A non low-profile balloon G tube extends further out of the stomach and has a disk on the outside to keep the tube from moving too far into the stomach. A low-profile balloon G tube sits close to the skin and is easy to conceal. </li><li>Balloon G tubes should be changed at least every six to eight months to prevent the balloon from leaking which can cause the G tube to accidentally fall out. </li><li>The G tube feeding extension set should be changed every month. </li><li>Whenever you change or re-insert a G tube, before using it for feeds and medications, always check the pH of the fluids that come from the tube to make sure it is in the stomach. </li><li>You do not need to go to the emergency department if your child’s balloon is broken, blocked or the tube accidentally falls and you replace the tube or insert a Foley catheter. You will only need to go the emergency department if you cannot insert an emergency Foley catheter and there is nothing in the tract. </li></ul><h2>What to do if your child’s balloon G tube is pulled out or becomes blocked</h2><h3>If the tube is accidentally pulled out</h3><p>It is possible that the G tube may accidentally fall out or be pulled out. This may happen if the balloon is broken or does not have enough water in it.</p><p>To check if the balloon is broken, fill it with 5 mL of water. If you do not see a leak, remove the water from the balloon, wash the G tube with soap and water and reinsert it into the stoma as described above. Fill the balloon with the amount of water you normally use. Check the balloon every two to three days to be sure there are no further problems.</p><p>If the balloon is broken, replace it with a new tube as described above.</p><p>If you cannot replace the G tube, insert a temporary Foley catheter. To learn how to insert the Foley catheter, please see the article “<a href="/Article?contentid=2910&language=English">What to do if your child’s feeding tube is pulled out</a>”. You can use the Foley catheter for feeds and medication until a new G tube inserted. </p><h3>If the tube becomes blocked</h3><p>To learn what to do if your child’s G tube becomes blocked, please see the article “<a href="/Article?contentid=3039&language=English">What to do if your child’s feeding tube is blocked</a>”.</p><p>Remember to always carry an emergency kit that includes: </p><ul><li>a back-up G tube or Foley catheter</li><li>water-based lubricant or jelly</li><li>syringes</li><li>water</li><li>pH strips and colour reference guide</li><li>tape in case of unexpected tube changes.</li></ul><p><strong>You do not need to go to the emergency department if the tube falls out or becomes blocked and you replace the tube or insert a Foley catheter.</strong> You will only need to go the emergency department if you cannot insert an emergency Foley catheter and there is nothing in the tract.</p><h2>Caring for your child’s balloon G tube</h2><p>Keep the tube and stoma as dry and clean as possible, washing with soap and water daily. Your child’s stoma will not need a dressing.</p><p>Flush the tube with at least 5 to 10 mL of water before and after each feed and medication dose, and every four hours during continuous feeds. This helps prevent the tube from becoming blocked. </p><h3>The balloon</h3><p>The balloon at the end of your child’s tube is what keeps the tube in place and prevents it from being accidentally pulled out. The balloon is inflated with sterile or distilled water. The water is inserted through the balloon port, marked “BAL”. Do not fill the balloon with saline or air. Do not feed into the balloon port. </p><p>If you are unsure how much water your child’s balloon tube can safely hold, ask your G tube specialist (at SickKids this is the G Tube Resource Nurse) or refer to the chart below.</p><table class="akh-table"><thead><tr><th>  </th><th colspan="2">Non-low profile<br></th><th colspan="2">Low-profile</th></tr></thead><tbody><tr><td> </td><td>Mic-G</td><td>Kangaroo</td><td>Mic-Key</td><td>AMT miniONE</td></tr><tr><td>12FR</td><td>3-5mL (max 7mL)</td><td>5mL </td><td>3 to 5mL</td><td>2 to 3mL</td></tr><tr><td>14FR</td><td>3-5mL (max 7mL)</td><td>5mL </td><td>5 to 10mL</td><td>4 to 5mL</td></tr></tbody></table><p>Filling the balloon with more or less water can affect the fit of the tube to the skin. Less water in the balloon makes the tube sit looser and stick out from the skin. More water in the balloon makes the tube sit tighter and closer to the skin. If the tube is so tight you can see an indent in your child’s skin, you can decrease the amount of water in the balloon. If the tube sticks out too much and is dangling from the stoma, you can increase the amount of water in the balloon. If adjusting the balloon volume does not help with the fit of your child’s tube, you may need to have the tract re-measured by your G tube specialist.</p><p>It is important to check the amount of water in the balloon at least once a week. This will help you to know if there is a problem with the balloon. Use a slip-tip syringe to check the balloon.</p><ol><li>Insert an empty syringe into the balloon port.</li><li>Remove all the water from the balloon. Throw away the old water. It is normal for the water to become discoloured (brown or yellow).</li><li>Re-inflate the balloon with new sterile or distilled water.</li></ol><p>It is normal for less water to be removed from the balloon than you originally put in. This is because some of the water might have evaporated. It is normal for there to be a difference of up to 0.5mL.</p><p>If there is a difference of more than 0.5 mL of water from what you put in and what you remove, the balloon may be damaged and the tube may need to be replaced. If this happens:</p><ul><li>Re-inflate the balloon with the amount of water you normally put in and check again in three to four hours. </li><li>If you get all the water back, the water may have simply evaporated quicker than usual. Re-inflate the balloon with the amount of water you normally put in and check the balloon volume every three to four days to be sure there are no further problems. </li><li>If you get less back again after three to four hours, the balloon is likely damaged and the tube will need to be replaced. </li><li>If you get more fluid than what you originally put in the balloon, and it looks like stomach contents or food, this means the balloon is definitely broken and the tube will need to be replaced. </li></ul><p>If you are concerned that the balloon is broken, there is a risk that the tube may be accidentally pulled out. Tape the tube in place until you can change the tube yourself or book an appointment with your G tube specialist to help you change the tube. Meanwhile, the tube is still in the stomach so you can continue to use the tube for feeding and medications. There is no need to go the emergency department if the balloon is broken. </p><h2>Feeding extension set for a low-profile balloon G tube</h2><p>The feeding port for a low-profile balloon G tube, where your child’s feeds will enter the tube and then go into their stomach, has a one-way valve to prevent stomach contents, feeds, water and medications from flowing back out of the tube. To open this one-way valve, and give feeds and medications, you must use a feeding extension set. Each brand has their own extension set. You will receive one in the box with your new low-profile balloon G tube. Replacement extension sets are purchased separately when needed. </p><h3>Connecting the extension set to the tube</h3><ol><li>Open the plastic cover.</li><li>Make sure the clamp on the extension set is closed.</li><li>Match the line on the extension to the line on the tube and push the extension into the valve.</li><li>Holding the tube in place, turn the extension clockwise until you feel the extension lock into place. There is an arrow on the extension to show you which direction to turn it. </li><li>Attach your feeds, fluids and medications to the appropriate port at the end and open the clamp.</li><li>When you have finished using the extension, flush it and remove it from the tube.</li></ol><h3>Removing the extension from the tube</h3><ol><li>Make sure the clamp on the extension set is closed.<br></li><li>Holding the tube in place, turn the extension counter-clockwise (opposite to the arrow on the extension).</li><li>Match the line on the extension to the line on the tube and remove the extension.</li><li>Close the plastic cover. </li></ol><p>The extension set should be changed once every month, or if you notice the plastic is becoming stiff or there is formula, food or medications built up inside. It is important to flush the extension set with water between each use and clean it with soap and water once daily. Remove the extension set from the tube when it is not in use to prevent pulling.</p><h2>How to change the balloon G tube</h2><div class="asset-video"> <iframe src="https://www.youtube.com/embed/_qW4lemX3rE?rel=0" frameborder="0"></iframe> <br></div> <h3>Supplies</h3><ul><li>New balloon G tube</li><li>Soap</li><li>Warm water</li><li>Washcloth</li><li>Sterile or distilled water</li><li>Four 5-mL slip-tip syringes</li><li>Water-based lubricant or jelly</li><li>Feeding extension set (for low-profile G tubes)</li><li>pH strips and colour reference guide</li></ul><h3>Procedure</h3><ol><li>Wash your hands with soap and water, and prepare your equipment and supplies.</li><li>Draw up the amount of water recommended to fill the balloon of your child’s tube into one syringe. Draw 5 mL of water into another syringe to flush the tube. Leave the other two syringes empty. You will use these to remove the old water from the balloon and checking the pH).</li><li>Prepare your washcloth with soap and water on one half of the cloth and non-soapy water on another part.</li><li>Check that the balloon of the new G tube is not broken by inflating the balloon with new water you have already drawn up. Gently squeeze the balloon to check for leaks caused by defects. Remove all the water from the balloon before continuing.</li><li>Remove the sterile or distilled water from the balloon of the old G tube using one of the empty syringes. Throw the water and syringe away.</li><li>Remove the old G tube. It is normal for the inner part of the tube to be brown or black. This is caused by acidic stomach contents. Throw away the old tube.</li><li>This is a great time to assess the stoma for any changes, such as redness, drainage, rash, or granulation tissue. Wash the stoma with soap and water and rinse it with non-soapy water. Then let it air dry.</li><li>Lubricate the tip of the new balloon G tube and, at a slight angle, insert it into the stoma, following the existing tract. The tube may be slightly resistant and it is okay to exert light force. Try to time insertion with when your child breaths in, as they are most relaxed at that time.</li><li>Once the tube is in place, inflate the balloon with the amount of sterile or distilled water you usually put in. Gently pull the tube until you feel resistance. This indicates that the balloon has reached the inside of the stomach wall.</li><li>Check that the tube is in the stomach by checking the pH as described below. Once you know the tube is in the stomach, by getting a pH of 6.0 or less, flush the tube with 5mL of water. If your child has a low-profile tube you will need to use the feeding extension set to flush the tube.</li><li>If your child has a non low-profile tube, adjust the outer disk so it sits snug against the skin. </li></ol><p>You may now use the tube for feeding and medications.</p><h2>Checking that the newly changed balloon tube is in the right spot</h2><p>Before using the newly changed tubes for feeds and medications, you will need to check that it is in the stomach by checking the pH of the contents that are pulled from the tube. </p><h3>How to check the pH</h3><p>You will need:</p><ul><li>One empty slip tip syringe</li><li>The feeding extension set for a low-profile balloon G tube (for low-profile tubes only)</li><li>pH strips</li><li>pH colour reference guide</li></ul><ol><li>Once you have inserted the new tube, insert the empty syringe into the extension feeding set (for a low-profile balloon G tube) or directly into the tube’s medication port (for a non low-profile balloon G tube) and pull back a small amount of stomach contents. If you cannot get stomach contents, move your child side to side or sit them up.</li><li>Empty the stomach contents from the syringe onto the pH strip.</li><li>Compare the colours on the pH strip to the colours on the reference guide.</li></ol><p> <strong>If the pH is 6.0 or less</strong>, the tube is in the stomach and you can flush the tube and use it for feeding and medications.</p><p> <strong>If the pH is higher than 6.0</strong>, the tube may not be in the stomach. Medications and recent feedings can affect the pH. <strong>If you get a high reading, do not use the tube for feeding or medications and check the pH again one hour later.</strong> If the reading is still higher than 6.0, do not use the tube and contact your G tube specialist to have the position checked in an interventional radiology department. </p><h2>Resources</h2><p>For more information about the Mic-Key, visit <a href="https://www.mic-key.com/">www.mic-key.com</a>.</p><p>For more information about the AMT miniONE, visit <a href="https://www.appliedmedical.net/enteral/minione/balloon/">www.appliedmedical.net/enteral/minione/balloon/</a>.</p>

 

 

G/GJ tubes: Balloon G tubes2908.00000000000G/GJ tubes: Balloon G tubesG/GJ tubes: Balloon G tubesGEnglishGastrointestinal;OtherChild (0-12 years);Teen (13-18 years)Abdomen;StomachDigestive systemNon-drug treatmentAdult (19+) CaregiversNA2018-10-25T04:00:00ZHolly Norgrove, RN, BScN7.1000000000000073.60000000000002861.00000000000Health (A-Z) - ProcedureHealth A-Z<p>A balloon G tube is a type of feeding tube that has a balloon on the end to help prevent the tube from being accidentally pulled out. Learn how to care for your child’s balloon G tube and change it at home. </p><p>Gastrostomy tubes (G tubes) are feeding devices that provide liquid nutrition, medications 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.</p><p>Balloon G tubes have a balloon on the end inside the stomach to keep the tube in place. These tubes may be non low-profile or low-profile.</p><h2>Types of balloon G tubes</h2><h3>Non low-profile balloon G tubes</h3><p>A non low-profile balloon G tube is a long type of feeding tube that extends further out of the stomach. It has a disk that sits on the outside of the stomach to prevent the tube from moving too far into the stomach. You can connect feeding bags and syringes directly into the tube.</p><p>There are several brands of non low-profile balloon tubes, including:</p><ul><li>Halyard Mic-G</li><li>Kangaroo</li><li>Cook Entuit</li></ul><h3>Low-profile balloon G tubes</h3><p>A low-profile balloon G tube is a type of feeding tube that sits close to the skin and is easy to conceal. These tubes are sometimes referred to as a “button” because of how they sit on the skin. It is very important to know the specific brand of tube your child has. Low-profile balloon G tubes need a special extension set to connect to the tube to feed your child.</p><p>There are several different brands of low-profile G tubes, including:</p><ul><li>Mic-Key</li><li>AMT MiniONE</li><li>Nutriport</li></ul><h2>Key points </h2><ul><li>A balloon G tube is a type of feeding tube that has a balloon on the end inside the stomach to prevent it from being pulled out. </li><li>A non low-profile balloon G tube extends further out of the stomach and has a disk on the outside to keep the tube from moving too far into the stomach. A low-profile balloon G tube sits close to the skin and is easy to conceal. </li><li>Balloon G tubes should be changed at least every six to eight months to prevent the balloon from leaking which can cause the G tube to accidentally fall out. </li><li>The G tube feeding extension set should be changed every month. </li><li>Whenever you change or re-insert a G tube, before using it for feeds and medications, always check the pH of the fluids that come from the tube to make sure it is in the stomach. </li><li>You do not need to go to the emergency department if your child’s balloon is broken, blocked or the tube accidentally falls and you replace the tube or insert a Foley catheter. You will only need to go the emergency department if you cannot insert an emergency Foley catheter and there is nothing in the tract. </li></ul><h2>What to do if your child’s balloon G tube is pulled out or becomes blocked</h2><h3>If the tube is accidentally pulled out</h3><p>It is possible that the G tube may accidentally fall out or be pulled out. This may happen if the balloon is broken or does not have enough water in it.</p><p>To check if the balloon is broken, fill it with 5 mL of water. If you do not see a leak, remove the water from the balloon, wash the G tube with soap and water and reinsert it into the stoma as described above. Fill the balloon with the amount of water you normally use. Check the balloon every two to three days to be sure there are no further problems.</p><p>If the balloon is broken, replace it with a new tube as described above.</p><p>If you cannot replace the G tube, insert a temporary Foley catheter. To learn how to insert the Foley catheter, please see the article “<a href="/Article?contentid=2910&language=English">What to do if your child’s feeding tube is pulled out</a>”. You can use the Foley catheter for feeds and medication until a new G tube inserted. </p><h3>If the tube becomes blocked</h3><p>To learn what to do if your child’s G tube becomes blocked, please see the article “<a href="/Article?contentid=3039&language=English">What to do if your child’s feeding tube is blocked</a>”.</p><p>Remember to always carry an emergency kit that includes: </p><ul><li>a back-up G tube or Foley catheter</li><li>water-based lubricant or jelly</li><li>syringes</li><li>water</li><li>pH strips and colour reference guide</li><li>tape in case of unexpected tube changes.</li></ul><p><strong>You do not need to go to the emergency department if the tube falls out or becomes blocked and you replace the tube or insert a Foley catheter.</strong> You will only need to go the emergency department if you cannot insert an emergency Foley catheter and there is nothing in the tract.</p><h2>Caring for your child’s balloon G tube</h2><p>Keep the tube and stoma as dry and clean as possible, washing with soap and water daily. Your child’s stoma will not need a dressing.</p><p>Flush the tube with at least 5 to 10 mL of water before and after each feed and medication dose, and every four hours during continuous feeds. This helps prevent the tube from becoming blocked. </p><h3>The balloon</h3><p>The balloon at the end of your child’s tube is what keeps the tube in place and prevents it from being accidentally pulled out. The balloon is inflated with sterile or distilled water. The water is inserted through the balloon port, marked “BAL”. Do not fill the balloon with saline or air. Do not feed into the balloon port. </p><p>If you are unsure how much water your child’s balloon tube can safely hold, ask your G tube specialist (at SickKids this is the G Tube Resource Nurse) or refer to the chart below.</p><table class="akh-table"><thead><tr><th>  </th><th colspan="2">Non-low profile<br></th><th colspan="2">Low-profile</th></tr></thead><tbody><tr><td> </td><td>Mic-G</td><td>Kangaroo</td><td>Mic-Key</td><td>AMT miniONE</td></tr><tr><td>12FR</td><td>3-5mL (max 7mL)</td><td>5mL </td><td>3 to 5mL</td><td>2 to 3mL</td></tr><tr><td>14FR</td><td>3-5mL (max 7mL)</td><td>5mL </td><td>5 to 10mL</td><td>4 to 5mL</td></tr></tbody></table><p>Filling the balloon with more or less water can affect the fit of the tube to the skin. Less water in the balloon makes the tube sit looser and stick out from the skin. More water in the balloon makes the tube sit tighter and closer to the skin. If the tube is so tight you can see an indent in your child’s skin, you can decrease the amount of water in the balloon. If the tube sticks out too much and is dangling from the stoma, you can increase the amount of water in the balloon. If adjusting the balloon volume does not help with the fit of your child’s tube, you may need to have the tract re-measured by your G tube specialist.</p><p>It is important to check the amount of water in the balloon at least once a week. This will help you to know if there is a problem with the balloon. Use a slip-tip syringe to check the balloon.</p><ol><li>Insert an empty syringe into the balloon port.</li><li>Remove all the water from the balloon. Throw away the old water. It is normal for the water to become discoloured (brown or yellow).</li><li>Re-inflate the balloon with new sterile or distilled water.</li></ol><p>It is normal for less water to be removed from the balloon than you originally put in. This is because some of the water might have evaporated. It is normal for there to be a difference of up to 0.5mL.</p><p>If there is a difference of more than 0.5 mL of water from what you put in and what you remove, the balloon may be damaged and the tube may need to be replaced. If this happens:</p><ul><li>Re-inflate the balloon with the amount of water you normally put in and check again in three to four hours. </li><li>If you get all the water back, the water may have simply evaporated quicker than usual. Re-inflate the balloon with the amount of water you normally put in and check the balloon volume every three to four days to be sure there are no further problems. </li><li>If you get less back again after three to four hours, the balloon is likely damaged and the tube will need to be replaced. </li><li>If you get more fluid than what you originally put in the balloon, and it looks like stomach contents or food, this means the balloon is definitely broken and the tube will need to be replaced. </li></ul><p>If you are concerned that the balloon is broken, there is a risk that the tube may be accidentally pulled out. Tape the tube in place until you can change the tube yourself or book an appointment with your G tube specialist to help you change the tube. Meanwhile, the tube is still in the stomach so you can continue to use the tube for feeding and medications. There is no need to go the emergency department if the balloon is broken. </p><h2>Feeding extension set for a low-profile balloon G tube</h2><p>The feeding port for a low-profile balloon G tube, where your child’s feeds will enter the tube and then go into their stomach, has a one-way valve to prevent stomach contents, feeds, water and medications from flowing back out of the tube. To open this one-way valve, and give feeds and medications, you must use a feeding extension set. Each brand has their own extension set. You will receive one in the box with your new low-profile balloon G tube. Replacement extension sets are purchased separately when needed. </p><h3>Connecting the extension set to the tube</h3><ol><li>Open the plastic cover.</li><li>Make sure the clamp on the extension set is closed.</li><li>Match the line on the extension to the line on the tube and push the extension into the valve.</li><li>Holding the tube in place, turn the extension clockwise until you feel the extension lock into place. There is an arrow on the extension to show you which direction to turn it. </li><li>Attach your feeds, fluids and medications to the appropriate port at the end and open the clamp.</li><li>When you have finished using the extension, flush it and remove it from the tube.</li></ol><h3>Removing the extension from the tube</h3><ol><li>Make sure the clamp on the extension set is closed.<br></li><li>Holding the tube in place, turn the extension counter-clockwise (opposite to the arrow on the extension).</li><li>Match the line on the extension to the line on the tube and remove the extension.</li><li>Close the plastic cover. </li></ol><p>The extension set should be changed once every month, or if you notice the plastic is becoming stiff or there is formula, food or medications built up inside. It is important to flush the extension set with water between each use and clean it with soap and water once daily. Remove the extension set from the tube when it is not in use to prevent pulling.</p><h2>How to change the balloon G tube</h2><div class="asset-video"> <iframe src="https://www.youtube.com/embed/_qW4lemX3rE?rel=0" frameborder="0"></iframe> <br></div> <h3>Supplies</h3><ul><li>New balloon G tube</li><li>Soap</li><li>Warm water</li><li>Washcloth</li><li>Sterile or distilled water</li><li>Four 5-mL slip-tip syringes</li><li>Water-based lubricant or jelly</li><li>Feeding extension set (for low-profile G tubes)</li><li>pH strips and colour reference guide</li></ul><h3>Procedure</h3><ol><li>Wash your hands with soap and water, and prepare your equipment and supplies.</li><li>Draw up the amount of water recommended to fill the balloon of your child’s tube into one syringe. Draw 5 mL of water into another syringe to flush the tube. Leave the other two syringes empty. You will use these to remove the old water from the balloon and checking the pH).</li><li>Prepare your washcloth with soap and water on one half of the cloth and non-soapy water on another part.</li><li>Check that the balloon of the new G tube is not broken by inflating the balloon with new water you have already drawn up. Gently squeeze the balloon to check for leaks caused by defects. Remove all the water from the balloon before continuing.</li><li>Remove the sterile or distilled water from the balloon of the old G tube using one of the empty syringes. Throw the water and syringe away.</li><li>Remove the old G tube. It is normal for the inner part of the tube to be brown or black. This is caused by acidic stomach contents. Throw away the old tube.</li><li>This is a great time to assess the stoma for any changes, such as redness, drainage, rash, or granulation tissue. Wash the stoma with soap and water and rinse it with non-soapy water. Then let it air dry.</li><li>Lubricate the tip of the new balloon G tube and, at a slight angle, insert it into the stoma, following the existing tract. The tube may be slightly resistant and it is okay to exert light force. Try to time insertion with when your child breaths in, as they are most relaxed at that time.</li><li>Once the tube is in place, inflate the balloon with the amount of sterile or distilled water you usually put in. Gently pull the tube until you feel resistance. This indicates that the balloon has reached the inside of the stomach wall.</li><li>Check that the tube is in the stomach by checking the pH as described below. Once you know the tube is in the stomach, by getting a pH of 6.0 or less, flush the tube with 5mL of water. If your child has a low-profile tube you will need to use the feeding extension set to flush the tube.</li><li>If your child has a non low-profile tube, adjust the outer disk so it sits snug against the skin. </li></ol><p>You may now use the tube for feeding and medications.</p><h2>Checking that the newly changed balloon tube is in the right spot</h2><p>Before using the newly changed tubes for feeds and medications, you will need to check that it is in the stomach by checking the pH of the contents that are pulled from the tube. </p><h3>How to check the pH</h3><p>You will need:</p><ul><li>One empty slip tip syringe</li><li>The feeding extension set for a low-profile balloon G tube (for low-profile tubes only)</li><li>pH strips</li><li>pH colour reference guide</li></ul><ol><li>Once you have inserted the new tube, insert the empty syringe into the extension feeding set (for a low-profile balloon G tube) or directly into the tube’s medication port (for a non low-profile balloon G tube) and pull back a small amount of stomach contents. If you cannot get stomach contents, move your child side to side or sit them up.</li><li>Empty the stomach contents from the syringe onto the pH strip.</li><li>Compare the colours on the pH strip to the colours on the reference guide.</li></ol><p> <strong>If the pH is 6.0 or less</strong>, the tube is in the stomach and you can flush the tube and use it for feeding and medications.</p><p> <strong>If the pH is higher than 6.0</strong>, the tube may not be in the stomach. Medications and recent feedings can affect the pH. <strong>If you get a high reading, do not use the tube for feeding or medications and check the pH again one hour later.</strong> If the reading is still higher than 6.0, do not use the tube and contact your G tube specialist to have the position checked in an interventional radiology department. </p><h2>How often should you change the balloon G tube?</h2><p>Most G tube manufacturers do not give a set time for how long you can use the tube. They suggest that it can stay in as long as it is functioning without leaks or defects. However, the tube should be changed at least every six to eight months to prevent leaks in the balloon, which could cause the tube to accidentally fall out.</p><p>When changing the tube, it is important to remember the risks involved.</p><p><em>Infection</em>: When you replace the tube, the stoma and the tract can become irritated and bacteria can be introduced. This increases the risk of <a href="/Article?contentid=2906&language=English">infection</a>. Always wash your hands before handling the tube, and whenever you have touched your child’s skin, and continue to clean the site with soap and water. Keep the site open to air.</p><p><em>Increased granulation tissue</em>: Removing an old tube and inserting a new one can irritate the skin and cause <a href="/Article?contentid=3019&language=English">granulation tissue</a>. This is a common occurrence. Your G tube specialist can help you deal with granulation tissue.</p><p><em>Perforation</em>: There is a possibility that, when inserting a new tube, the tube is not inserted along the existing tract. It could create a new tract and space inside the body. This is extremely rare. If your child has instant intolerance (vomiting) or severe pain after their first feeding with a new tube, go to the emergency department for assistance. A G tube check may need to be scheduled in the interventional radiology department. Perforation can lead to a condition called peritonitis. </p><h2>Resources</h2><p>For more information about the Mic-Key, visit <a href="https://www.mic-key.com/">www.mic-key.com</a>.</p><p>For more information about the AMT miniONE, visit <a href="https://www.appliedmedical.net/enteral/minione/balloon/">www.appliedmedical.net/enteral/minione/balloon/</a>.</p>G/GJ tubes: Balloon G tubesFalse

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