G/GJ tubes: Permanent feeding tube removalGG/GJ tubes: Permanent feeding tube removalG/GJ tubes: Permanent feeding tube removalEnglishGastrointestinal;OtherChild (0-12 years);Teen (13-18 years)Stomach;Abdomen;Small IntestineDigestive systemProceduresAdult (19+) CaregiversNA2018-12-20T05:00:00ZHolly Norgrove, RN, BScN7.2000000000000073.30000000000001114.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Learn how you can help your child prepare for the removal of their G or GJ tube, how to remove the tube at home and care for your child's tract after the feeding tube removal.</p><p>A G or GJ tube may be a permanent way to feed some children. For others, it is temporary and may be removed in the future. You and your child’s health-care team will decide when to remove the feeding tube according to your child’s history.</p><h2>Key points</h2><ul><li>Your child must be able to take all their nutrition, fluids, and medications by mouth for at least two to three months before their G tube or GJ tube is removed.</li><li>If your child is scheduled for surgery or a procedure that may affect their ability to take nutrition, fluids, or medication by mouth, you should consider delaying the removal of the tube.</li><li>If your child has a balloon-type tube, you may remove the tube yourself.</li><li>Once the tube is removed, stomach contents will leak from the stoma and will continue to do so until the tract closes completely.</li><li>It may take more than two weeks for the feeding tube tract to heal and close, and it will leak during this time.</li><li>If the stoma is still leaking two weeks after the tube has been removed, call your G tube specialist for further assessment.</li><li>After tube removal, it is important to wash the stoma with soap and water daily to prevent infection. Do not submerge your child in water until the feeding tube tract has stopped leaking. </li></ul><h2>When to see a doctor</h2><p>Always watch for signs of <a href="/article?contentid=2906&language=english">infection</a>, such as redness, swelling, pain, and fever. See your family doctor or paediatrician if your child is experiencing these symptoms.</p><p>If the stoma is still leaking two weeks after the tube has been removed, call your G tube specialist (at SickKids this is the G Tube Resource Nurse) for further assessment. Your child may need stitches to close the tract.</p><h2>Tube removal</h2><p>If your child has a <a href="/article?contentid=2908&language=english">balloon-type tube</a>, you may remove the tube yourself or have your child’s doctor remove it. There are several different balloon-type tubes:<br></p><ul><li>Halyard Mic-G or Kangaroo G tube</li><li>Low-profile G or GJ tube (also known as a “button” tube), such as a Mic-Key, Nutriport, and AMT Mini One</li><li>Foley catheter</li></ul><p>The balloon will need to be emptied before the tube is removed. If possible, remove your child’s feeding tube before bed time. This will allow the stoma to heal for several hours without feedings and with minimal movement from your child while they sleep.</p><p>Once the tube is removed, stomach contents will leak from the stoma and will continue to do so until the tract closes completely.</p><h3>Removing a Mic-G, Kangaroo or Foley catheter</h3><p>Insert a slip-tip syringe into the hard plastic port and withdraw all the water from the balloon. Remove the tube. You may need to pull with a small amount of force to dislodge the tube.</p><h3>Removing a low-profile G or GJ tube</h3><p>Insert a slip-tip syringe into the balloon port – marked “BAL” – and withdraw all the water from the balloon. Remove the tube. You may need to pull with a small amount of force to dislodge the tube.</p><h2>After the feeding tube is permanently removed</h2> <figure><span class="asset-image-title">Stoma after tube removal</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/GTube_Stoma_FreshlyRemovedGtube.jpg" alt="stoma after g tube is removed" /> </figure> <h3>Stoma and feeding tube tract healing process</h3><p>Your child’s tract will start to heal and close within hours of removing the feeding tube but it can take more than two weeks to close completely. It will leak during this time. After the tract closes, your child will have a small scar that may look like a dimple or a healed earring hole.</p><h3>How to protect your child’s skin</h3><p>To protect the skin from the acidic stomach contents, apply a zinc oxide barrier cream around the stoma and continue to apply a gauze dressing over the site, secured to the tummy with tape as long as it leaks. This dressing should be changed daily or when it is soaked. Do not be alarmed if you see some of the food and drink your child is eating on the gauze. This is normal. There are no food or drink restrictions for your child while their tract is healing. They can continue to eat and drink all of their regular food and beverages by mouth.<br></p><h3>Keeping the stoma clean</h3><p>Do not submerge your child in water until the tract is fully closed. This means no baths or swimming until there is no more leakage. Sponge baths and showers are okay during this time.</p><p>It is important to wash the stoma with soap and water daily to prevent <a href="/article?contentid=2906&language=english">infection</a>. Be gentle; do not rub the stoma. Allow the soap, shampoo and water to lightly wash over the site.</p><p>Once the leaking stops, the stoma will scab over and your child will no longer need a gauze dressing.</p><h2>How long has it been since your child last used their feeding tube?</h2><p>Has your child taken all of their nutrition (food or formula), fluids (water), and medications by mouth for at least three months? Has your child used their feeding tube in the last three months? It is important to answer these questions to prove that:</p><ul><li>your child is no longer dependent upon their G or GJ tube</li><li>your child can take all their nutrition, fluids, and medications by mouth, even when they are sick </li></ul><p>Two to three months without using the G or GJ tube is generally enough time to know whether your child will continue to take everything by mouth in the future. However, this is only a general guideline and you should discuss your child’s personal history with their health-care team.</p><p>Many medications that have previously been given through the G tube or GJ tube taste very bitter. It is important to consider the taste of a medication and how well it will be tolerated by your child when switching to medications by mouth. There may be alternative medications that taste better. Speak to your child’s health-care provider about medication options.</p><h2>Some medical procedures may affect your child’s ability to feed</h2><p>Is your child scheduled for a major surgery or procedure that may affect their ability to take nutrition, fluids, or medications by mouth? If the answer to this question is 'yes', then it may be better to leave your child’s feeding tube in until your child recovers from this procedure. Your child’s health-care provider and the surgeon performing the procedure will be able to help you decide.</p><p>If your child is a SickKids patient, contact the G Tube Resource Nurse with any concerns.</p><h3>G Tube Resource Nurse contact info:</h3><p>Phone: 416-813-7177</p><p>Email: g.tubenurse@sickkids.ca</p>
Sondes gastriques (G) et sondes gastrojéjunales (GJ) : retrait de la sonde d’alimentation permanenteSSondes gastriques (G) et sondes gastrojéjunales (GJ) : retrait de la sonde d’alimentation permanenteG/GJ tubes: Permanent feeding tube removalFrenchGastrointestinal;OtherChild (0-12 years);Teen (13-18 years)Stomach;Abdomen;Small IntestineDigestive systemProceduresAdult (19+) CaregiversNA2018-12-20T05:00:00ZHolly Norgrove, RN, BScNHealth (A-Z) - ProcedureHealth A-Z<p>Apprenez comment vous pouvez aider votre enfant à se préparer au retrait de sa sonde gastrique (G) ou de sa sonde gastrojéjunale (GJ), ainsi qu’à retirer la sonde à la maison et à prendre soin du tube une fois la sonde d’alimentation retirée.</p><p>Pour certains enfants, la sonde G ou la sonde GJ sera requise de manière permanente pour l’alimentation tandis qu’elle sera temporaire pour d’autres et pourra être retirée après un certain temps. L’équipe responsable des soins de votre enfant décidera de concert avec vous du moment qui convient pour retirer la sonde d’alimentation en fonction des antécédents de l’enfant.</p><h2>À retenir</h2><ul><li>Votre enfant doit être en mesure d’absorber tous ses aliments, ses liquides et ses médicaments par la bouche pendant au moins deux ou trois mois avant le retrait de sa sonde gastrique (G) ou gastrojéjunale (GJ).</li><li>Dans le cas où votre enfant doit subir une opération ou qu’une intervention risque d’influencer sa capacité d’absorber les aliments, les liquides ou les médicaments par la bouche, vous devrez peut-être remettre à plus tard le retrait de la sonde.</li><li>Si votre enfant est muni d’une sonde à ballonnet, vous pouvez la retirer vous-même.</li><li>Une fois la sonde retirée, vous pourrez observer que le contenu de l’estomac fuit par la stomie. Il en sera ainsi jusqu’à ce que le tube se soude en se refermant complètement.</li><li>La guérison et la fermeture complète du tube pourrait exiger plus de deux semaines; la stomie fuira pendant cette période.</li><li>Si la stomie fuit encore deux semaines après le retrait de la sonde, appelez votre expert des sondes G afin qu’il procède à une évaluation approfondie.</li><li>Une fois la sonde retirée, il est important de nettoyer chaque jour la stomie au savon et à l’eau pour prévenir l’infection. Évitez d’immerger l’enfant dans l’eau tant que fuit le tube.</li></ul><h2>Quand consulter un médecin</h2><p>Surveillez attentivement les signes d’<a href="/Article?contentid=2906&language=French">infection</a> comme la rougeur, l’enflure, la douleur et la fièvre. Consultez votre médecin de famille ou votre pédiatre si votre enfant présente ces symptômes.</p><p>Si la stomie continue de fuir deux semaines après le retrait de la sonde, appelez votre expert des sondes G (à l’hôpital SickKids, notre infirmier-ressource pour les sondes G joue ce rôle) qui procédera à une évaluation appropriée. Il se peut que des points de suture soient nécessaires pour fermer le tube.</p><h2>Retrait de la sonde</h2><p>Si votre enfant est muni d’une <a href="/Article?contentid=2908&language=French">sonde à ballonnet</a>, le médecin de votre enfant ou vous pouvez retirer la sonde. Il existe différentes sondes à ballonnet :<br></p><ul><li>Sonde Halyard Mic-G ou Kangaroo G</li><li>Sonde G ou GJ discrète (également appelée « sonde bouton »), telle que Mic-Key, Nutriport et AMT MiniOne</li><li>Cathéter de Foley</li></ul><p>Le ballonnet devra être vidé avant de retirer la sonde. Si possible, retirez la sonde d’alimentation de votre enfant avant l’heure du coucher afin de permettre à la stomie de guérir pendant plusieurs heures d’accalmie (mouvements du corps minimaux pendant le sommeil) avant le prochain passage des aliments. Une fois la sonde retirée, le contenu de l’estomac fuira par la stomie et ce processus se poursuivra jusqu’à ce que le tube se referme complètement.</p><h3>Retrait d’un cathéter de Foley, d’un Mic-G ou d’un Kangaroo</h3><p>Introduisez une seringue à embout glissant dans l’orifice en plastique dur et retirez toute l’eau du ballonnet. Retirez la sonde. Il se peut que vous ayez à tirer un peu plus fort pour la déloger.</p><h3>Retrait d’une sonde G ou GJ discrète</h3><p>Introduisez une seringue à embout glissant dans l’orifice du ballonnet – sur lequel est inscrit « BAL » – et retirez toute l’eau du ballonnet. Retirez la sonde. Il se peut que vous ayez à tirer un peu plus fort pour la déloger.</p><h2>Après le retrait permanent de la sonde d’alimentation</h2> <figure><span class="asset-image-title">Stomie après retrait du tube</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/GTube_Stoma_FreshlyRemovedGtube.jpg" alt="" /> </figure> <h3>Processus de guérison du tube formé par la sonde d’alimentation et la stomie</h3><p>Le tube commencera à guérir et à se refermer quelques heures après le retrait de la sonde d’alimentation, mais il faudra plus de deux semaines pour qu’il se ferme complètement. La stomie fuira entretemps. Une petite cicatrice pouvant ressembler à une fossette ou à un trou pratiqué pour le port d’une boucle d’oreille se formera après la fermeture du tube.</p><h3>Comment protéger la peau de votre enfant</h3><p>Afin de protéger la peau contre le contenu acide de l’estomac, appliquez une barrière protectrice à base d’oxyde de zinc autour de la stomie et continuez à panser la plaie avec une gaze stérile tenue en place avec un ruban adhésif aussi longtemps que durera la fuite. Ce pansement doit être changé chaque jour ou lorsqu’il est imbibé. Ne soyez pas étonné de voir sur la gaze ce que votre enfant a mangé et bu. C’est normal. À cette étape de la guérison du tube, il n’y a aucune restriction sur le plan des aliments et des liquides. Votre enfant peut continuer à manger et à boire par la bouche sans changer ses habitudes. </p><h3>Garder la stomie propre</h3><p>Évitez de faire entrer la stomie en contact avec de l’eau tant qu’elle n’est pas complètement fermée : ni bain ni baignade jusqu’à ce que la stomie ne fuit plus. Votre enfant peut toutefois prendre sa douche ou faire sa toilette à l’éponge. Il est important de nettoyer chaque jour la stomie à l’eau et au savon afin de prévenir l’<a href="/Article?contentid=2906&language=French">infection</a>. Allez-y doucement avec la stomie sans la frotter; le savon, le shampoing et l’eau doivent couler librement sur la stomie. Une fois la fuite arrêtée, une gale se formera sur la stomie et votre enfant n’aura plus besoin d’un pansement de gaze.<br></p><h2>Quand votre enfant s’est-il servi de sa sonde d’alimentation pour la dernière fois?</h2><p>Votre enfant s’est-il alimenté (solides ou préparation lactée) et a t il absorbé des liquides et pris des médicaments entièrement par la bouche pendant au moins trois mois? A-t-il utilisé sa sonde d’alimentation au cours des trois derniers mois? Il est important de répondre à ces questions afin de prouver que :</p><ul><li>votre enfant ne dépend plus de sa sonde G ou GJ;</li><li>il peut prendre tous ses aliments, ses liquides et ses médicaments par la bouche, même quand il est malade.</li></ul><p>Une période de deux à trois mois sans utiliser la sonde G ou GJ est en général suffisante pour confirmer que votre enfant continuera à tout absorber par la bouche à l’avenir. Il s’agit toutefois d’une ligne directrice générale et il est préférable de discuter de ses antécédents avec l’équipe responsable de ses soins.</p><p>Un grand nombre de médicaments qui ont été administrés à votre enfant par la sonde G ou GJ ont un goût très amer. Il est très important de tenir compte du goût d’un médicament et du degré de tolérance de votre enfant à son égard lorsqu’il est question d’adopter la prise de médicaments par la bouche. Nous vous suggérons de discuter des choix possibles en matière de médicaments avec le fournisseur de soins de votre enfant.</p><h2>Certaines interventions médicales peuvent influer sur la capacité de votre enfant à s’alimenter</h2><p>Votre enfant doit-il bientôt subir une importante opération ou intervention susceptible d’altérer sa capacité d’absorber les aliments, les liquides ou les médicaments par la bouche? Dans l’affirmative, il est préférable de laisser la sonde en place jusqu’à ce qu’il se rétablisse après cette opération. Le fournisseur de soins de votre enfant et le chirurgien responsable de l’intervention pourront vous aider à prendre une décision.</p><p>Si votre enfant est un patient de SickKids, communiquez avec l’infirmier-ressource pour les sondes G en cas de préoccupations quelconques.</p><h3>Coordonnées de l’infirmier-ressource :</h3><p>Numéro de téléphone : 416 813 7177</p><p>Téléavertisseur : 416 377 1271</p><p>g.tubenurse@sickkids.ca</p>

 

 

 

 

G/GJ tubes: Permanent feeding tube removal3036.00000000000G/GJ tubes: Permanent feeding tube removalG/GJ tubes: Permanent feeding tube removalGEnglishGastrointestinal;OtherChild (0-12 years);Teen (13-18 years)Stomach;Abdomen;Small IntestineDigestive systemProceduresAdult (19+) CaregiversNA2018-12-20T05:00:00ZHolly Norgrove, RN, BScN7.2000000000000073.30000000000001114.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Learn how you can help your child prepare for the removal of their G or GJ tube, how to remove the tube at home and care for your child's tract after the feeding tube removal.</p><p>A G or GJ tube may be a permanent way to feed some children. For others, it is temporary and may be removed in the future. You and your child’s health-care team will decide when to remove the feeding tube according to your child’s history.</p><h2>Key points</h2><ul><li>Your child must be able to take all their nutrition, fluids, and medications by mouth for at least two to three months before their G tube or GJ tube is removed.</li><li>If your child is scheduled for surgery or a procedure that may affect their ability to take nutrition, fluids, or medication by mouth, you should consider delaying the removal of the tube.</li><li>If your child has a balloon-type tube, you may remove the tube yourself.</li><li>Once the tube is removed, stomach contents will leak from the stoma and will continue to do so until the tract closes completely.</li><li>It may take more than two weeks for the feeding tube tract to heal and close, and it will leak during this time.</li><li>If the stoma is still leaking two weeks after the tube has been removed, call your G tube specialist for further assessment.</li><li>After tube removal, it is important to wash the stoma with soap and water daily to prevent infection. Do not submerge your child in water until the feeding tube tract has stopped leaking. </li></ul><h2>When to see a doctor</h2><p>Always watch for signs of <a href="/article?contentid=2906&language=english">infection</a>, such as redness, swelling, pain, and fever. See your family doctor or paediatrician if your child is experiencing these symptoms.</p><p>If the stoma is still leaking two weeks after the tube has been removed, call your G tube specialist (at SickKids this is the G Tube Resource Nurse) for further assessment. Your child may need stitches to close the tract.</p><h2>Tube removal</h2><p>If your child has a <a href="/article?contentid=2908&language=english">balloon-type tube</a>, you may remove the tube yourself or have your child’s doctor remove it. There are several different balloon-type tubes:<br></p><ul><li>Halyard Mic-G or Kangaroo G tube</li><li>Low-profile G or GJ tube (also known as a “button” tube), such as a Mic-Key, Nutriport, and AMT Mini One</li><li>Foley catheter</li></ul><p>The balloon will need to be emptied before the tube is removed. If possible, remove your child’s feeding tube before bed time. This will allow the stoma to heal for several hours without feedings and with minimal movement from your child while they sleep.</p><p>Once the tube is removed, stomach contents will leak from the stoma and will continue to do so until the tract closes completely.</p><h3>Removing a Mic-G, Kangaroo or Foley catheter</h3><p>Insert a slip-tip syringe into the hard plastic port and withdraw all the water from the balloon. Remove the tube. You may need to pull with a small amount of force to dislodge the tube.</p><h3>Removing a low-profile G or GJ tube</h3><p>Insert a slip-tip syringe into the balloon port – marked “BAL” – and withdraw all the water from the balloon. Remove the tube. You may need to pull with a small amount of force to dislodge the tube.</p><h2>After the feeding tube is permanently removed</h2> <figure><span class="asset-image-title">Stoma after tube removal</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/GTube_Stoma_FreshlyRemovedGtube.jpg" alt="stoma after g tube is removed" /> </figure> <h3>Stoma and feeding tube tract healing process</h3><p>Your child’s tract will start to heal and close within hours of removing the feeding tube but it can take more than two weeks to close completely. It will leak during this time. After the tract closes, your child will have a small scar that may look like a dimple or a healed earring hole.</p><h3>How to protect your child’s skin</h3><p>To protect the skin from the acidic stomach contents, apply a zinc oxide barrier cream around the stoma and continue to apply a gauze dressing over the site, secured to the tummy with tape as long as it leaks. This dressing should be changed daily or when it is soaked. Do not be alarmed if you see some of the food and drink your child is eating on the gauze. This is normal. There are no food or drink restrictions for your child while their tract is healing. They can continue to eat and drink all of their regular food and beverages by mouth.<br></p><h3>Keeping the stoma clean</h3><p>Do not submerge your child in water until the tract is fully closed. This means no baths or swimming until there is no more leakage. Sponge baths and showers are okay during this time.</p><p>It is important to wash the stoma with soap and water daily to prevent <a href="/article?contentid=2906&language=english">infection</a>. Be gentle; do not rub the stoma. Allow the soap, shampoo and water to lightly wash over the site.</p><p>Once the leaking stops, the stoma will scab over and your child will no longer need a gauze dressing.</p><h2>How long has it been since your child last used their feeding tube?</h2><p>Has your child taken all of their nutrition (food or formula), fluids (water), and medications by mouth for at least three months? Has your child used their feeding tube in the last three months? It is important to answer these questions to prove that:</p><ul><li>your child is no longer dependent upon their G or GJ tube</li><li>your child can take all their nutrition, fluids, and medications by mouth, even when they are sick </li></ul><p>Two to three months without using the G or GJ tube is generally enough time to know whether your child will continue to take everything by mouth in the future. However, this is only a general guideline and you should discuss your child’s personal history with their health-care team.</p><p>Many medications that have previously been given through the G tube or GJ tube taste very bitter. It is important to consider the taste of a medication and how well it will be tolerated by your child when switching to medications by mouth. There may be alternative medications that taste better. Speak to your child’s health-care provider about medication options.</p><h2>Some medical procedures may affect your child’s ability to feed</h2><p>Is your child scheduled for a major surgery or procedure that may affect their ability to take nutrition, fluids, or medications by mouth? If the answer to this question is 'yes', then it may be better to leave your child’s feeding tube in until your child recovers from this procedure. Your child’s health-care provider and the surgeon performing the procedure will be able to help you decide.</p><p>If your child is a SickKids patient, contact the G Tube Resource Nurse with any concerns.</p><h3>G Tube Resource Nurse contact info:</h3><p>Phone: 416-813-7177</p><p>Email: g.tubenurse@sickkids.ca</p>G/GJ tubes: Permanent feeding tube removalFalse