G/GJ tubes: Sensitivity and irritation

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

Signs of sensitivity and irritation

Skin irritation

Some children have sensitive skin and may be more likely to experience irritation around the stoma than other children. Your child's skin may be irritated if you notice:

• breakouts around the stoma (tiny bumps or pimples)
• rashes
• blotches
• the skin becomes itchy when exposed to an irritant

Causes of sensitivity or irritation

Skin irritation from tape

Your child’s skin may get sore and red because it touches an irritant. The following are common irritants:

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

Protection of your child’s skin

The most effective way to treat irritation and sensitivity around the stoma is to make sure your child's skin is protected from irritants.

• If the irritation is caused by the tape used to secure your child’s tube to their skin, change the type of tape you use.
• Use a barrier tape. This is a layer of soft, spongy, flexible, waterproof tape that acts like a second skin. 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 laundry 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).
• If the irritation is caused by stoma leakage, use barrier creams such as zinc oxide or other diaper rash creams to protect the skin around the stoma.
• You may use a foam or G tube pad between the tube and the stoma .

If you notice skin inflammation, dryness and/or rash, contact your G tube specialist for treatment information.

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 put dressings on the stoma unless your health-care team advises you to do so.
• Keep the stoma dry. Do not apply ointments or creams unless your health-care team advises you to do so.
• Always secure the feeding tube well to avoid friction against the skin.
• Avoid too much movement of the tube in the tract.
• Address stoma leakage as soon as possible.
• Prevent infection.
• For a low profile tube :
• Make sure your child’s tube fits properly.
• Check the volume of the tube’s balloon weekly.
• If you think your child’s balloon-type G tube is too loose or too tight, contact your G tube team to re-measure the size of the tube.

For more information on treatment of stoma issues, please see the SickKids Enterostomy Tube Stoma Assessment Clinical Practice Guideline.

At SickKids

If your child is a SickKids patient, contact the G Tube Resource Nurse with any concerns.

G Tube Resource Nurse contact info:

Phone: 416-813-7177

Email: g.tubenurse@sickkids.ca

On weekends/afterhours, you may need to come to the Emergency Department for an alternate method of feed/fluids/medication administration.