Abdominal and Digestive Home Care

Gastrostomy Tube (G-Tube) Home Care

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Explanation About Gastrostomy / G-Tubes

Your child has had a tube placed in his / her stomach called a gastrostomy tube or g-tube. This tube provides an alternate way to offer food and / or medicines. It also can be used to vent your child's stomach for air or drainage.

When the tube is first placed in your child's stomach it may or may not be secured with a stitch through the skin and around the tube. This helps the tube stay in place until the gastrostomy tract is well healed. If your child has a stitch around the tube, healing takes place in about 21 days. A tract will form between the stomach and skin in about 3 months. Your doctor may talk to you about changing the tube at this time.

Supplies Needed

Soap and water
Clean gauze pads
Scissors
Tape
Syringe for flushing
Water for flushing

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Cleaning and Dressing the Wound

Wash your hands with soap and water.
Remove old dressing. Look at the area where the tube enters the skin. Check for redness, swelling, any drainage or excess skin growing around the tube. A small amount of clear tan drainage can be normal.
Wash skin around the tube with soap and warm water. Clean around g-tube to remove any drainage and / or crusting. Clean around suture gently. Dry skin thoroughly. The site should be kept clean and dry.
Redress as you have been instructed by your doctor or nurse. Anchor the end of the tube by putting a piece of tape around the tube and pinning it to a folded piece of tape on his / her stomach or pin it to his / her diaper or T-shirt. Onsies or tubular dressings also help safely secure the tube.
Do not use ointments around tube site unless directed by your child's doctor or nurse.

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Flushing the G-Tube

It is important to flush your child's g-tube before and after any tube feedings, before and after any medications or at least every eight hours. Usually 3-10 ml of water will clear the tube; however, your doctor or nurse will tell you the amount to give your child.

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Giving Medicines

Liquid medications may be injected directly into the tube after the tube has been flushed.
For pills first check with your doctor or pharmacist before crushing any medications. Crush the medicines into a powder and mix with enough water to make a liquid (1-10 mls).
For capsules, first check with your doctor or pharmacist before opening the capsule. Open and dissolve powder with enough water to make a liquid (1-10 mls).
Remember: do not mix medicines unless directed by your health care team.

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Venting the Tube

You may need to vent your child's tube to remove excess air or fluid in your child's stomach. It can be done 2 different ways. Your doctor or nurse will tell you if this is needed.
Open the G-tube port and attach to a drainage device (such as a mucous trap or drainage bag). You may be asked to measure and record the amount of drainage.
Your physician may instruct you to vent the g-tube using a catheter-tip syringe and aspirating the excess air or gastric fluid from stomach. This is used for bloating, distension or gagging. You may be asked to measure and record any drainage and frequency.

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Protecting the G-Tube

Do not allow your child to pull on the tube. One piece, snap T-shirt works best for infants and toddlers. Keep the tube secured beneath the child's clothing.

Problem-Solving

Problems	Causes	Solutions
G-tube was pulled out.		Cover with small clean dressing and tape. Then call doctor or nurse. The g-tube needs to be put in as soon as possible within 1- 4 hours so the tract will not close. Bring your old tube to either the doctor's office or emergency room.
Redness and irritation around the stomach, soreness and foul odor.	May be caused by leakage or infection.	Continue routine care and contact your child's doctor. A skin barrier cream may be ordered at this time.
Leaking	Malfunctioning tube Increase air	Keep dressing clean and dry. Try more frequent venting. Call your child's doctor or nurse. The tube may need to be replaced.
Skin or excess tissue appears to be growing where tube enters skin.	Some children are more prone to this than others.	Call your child's doctor or nurse to discuss treatment.
G-tube is clogged.	Thick formulas or medication.	Try to slowly push warm water into the tube with a 10 ml syringe. Repeat steps every 10-15 minutes. Never put any object into the tube to unclog it. If you are unable to unclog the tube call your child's doctor or nurse.

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Tips

It is important that you know what type and size tube your child has. Be sure to check with your doctor or nurse to get this information.
Discuss ways to develop oral motor skills for your child with your doctor.
Always call your doctor or nurse if you have questions or problems.

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