Learn how to remove the feeding tube at home, if appropriate, and care for your child's tract after the permanent feeding tube removal.
Key points
If your child has a balloon-type G tube, you may remove the tube yourself.
Once the tube is removed, stomach contents will leak from the stoma and will continue to do so until the tract closes completely.
It may take up to two weeks for the feeding tube tract to heal and close, and it will leak during this time.
If the stoma is still leaking two weeks after the tube has been removed, call your G tube specialist for further assessment.
After tube removal, it is important to wash the stoma with soap and water daily to prevent infection.
Do not submerge your child’s stoma in water until the feeding tube tract has stopped leaking.
Introduction
A G, GJ or combination G/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.
Procedure overview
Tube removal
If your child has a balloon-type G tube, you may remove the tube yourself or have a health-care professional remove it. There are several different balloon-type G tubes:
Halyard Mic-G or Kangaroo G tube
Foley catheter
Low-profile G tube (also known as a "button" tube), such as a Mic-Key, Nutriport, and AMT Mini One)
If possible, remove your child’s feeding tube before bedtime. This will allow the stoma to heal for several hours without feedings and with minimal movement from your child while they sleep.
Once the tube is removed, stomach contents will leak from the stoma and will continue to do so until the tract closes completely.
Removing a non low-profile tube (such as a Mic-G, Kangaroo or Foley catheter)
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.
Removing a low-profile G tube (such as a Mic-Key, Nutriport, and AMT Mini One)
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.
The following tubes should not be removed at home:
Corflo PEG tubes require a general anaesthetic to be removed and will be removed in Image Guided Therapy (IGT)
Mac Loc tubes can be removed by your G tube specialist in clinic
GJ or combination G/GJ balloon tubes can be removed by your G tube specialist in clinic
After the procedure
After the feeding tube is permanently removed
Stoma after tube removal
Stoma and feeding tube tract healing process
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.
How to protect your child’s skin
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 for 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.
Keeping the stoma clean
Do not submerge your child in water until the tract is fully closed. This means no baths or swimming until leakage has stopped. It is OK to sit in the bath if the water is below the stoma. Swimming can be considered if a waterproof bandage is covering the stoma. Sponge baths and showers are OK during this time.
It is important to wash the stoma with soap and water daily to prevent
infection. Be gentle; do not rub the stoma. Allow the soap, shampoo and water to lightly wash over the site.
Once the leaking stops, the stoma will scab over and your child will no longer need a gauze dressing.
When to seek medical attention
When to see a doctor
Always watch for signs of
infection, such as redness, swelling, pain, and fever. See your primary care provider if your child is experiencing these symptoms.
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.
At SickKids
If your child is a SickKids patient, contact the G Tube Resource Nurse with any concerns.
