How to Care for a Gastronomy Tube at Home
Follow At-Home Guide for Newly Created Gastrostomy Tubes
Your child has had a tube placed in his / her stomach called a gastrostomy tube or G-tube. This tube provides another 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 three months. Your doctor may talk to you about changing the tube at this time.
It is important to know what type and size tube your child has.
- Brand of G-tube
- Size of tube (Fr)
- Balloon / non-balloon
It is also important for you to know the name and phone number of the doctor managing your child’s care.
Supplies Needed for G-Tube Care
- Clean work area
- Soap and water
- Wash cloth and towel
- Clean gauze pads (if needed)
- Extension set
- Securement device
- Syringe for flushing
- Water for flushing
- Wash your hands with soap and water before and after care.
- Remove old dressing (if dressing is being used). 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. Call your child’s care team with any concerns.
- Wash skin around the tube with soap and warm water. Clean around G-tube to remove any drainage and / or crusting. Rinse soap off with clear water. Dry skin thoroughly. Keep this site clean and dry.
- A dressing may be used around the G-tube site as instructed by your care team.
- Do not use lotions or ointments around tube site unless directed by your child's care team.
- Cleaning the G-Tube Area - YouTube
Giving Medications and Flushing the G-Tube
Your care team will tell you how much water to use for flushing.
Flush your child’s G-tube with water:
- Before and after any tube feeding
- Before and after any medications (all medication should not be visible in the tube or extension after flushing)
- At least once every 24 hours
- Give liquid medications directly into the medication port.
- For pills, 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.
- For capsules, check with your doctor or pharmacist before opening the capsule. Open and dissolve powder with enough water to make a liquid.
- Always give one medication at a time and give water in between each medication.
- Extension sets are disposable and you should change them regularly. Check with your insurance provider to see how many sets you will receive each month. Remove it from the G-tube when not in use, feeding or giving medications.
- Clean extension sets daily with warm water; rinse well; allow to air dry on clean surface.
- Throw away the extension set if you are unable to clean the residue, the plastic becomes damaged or kinks during feeds.
Venting the Tube
- Your child's tube may need to be used to remove extra air or fluid from your child's stomach. Your care team will tell you if this is needed.
- There are several devices you can use to vent the G-tube.
- Follow instructions from your care team on how to do this.
- Bathe as usual – use mild soap and warm water to clean g-tube site and dry thoroughly.
- Most play activities including tummy time are allowed. Secure the tube so it cannot be pulled.
- Check for leaking after activities and call your care team if any leaking is found.
- Do not allow your child to pull on the tube. Keep the tube secured beneath the child's clothing. A one-piece, snap T-shirt works best for infants and toddlers. X-span or an ace wrap can be used for older children. Discuss with your child’s care team any concerns you may have about keeping the tube secure. Secure the extension set to the belly during drip feeds. Remove the extension set from the button G-tube when you are not giving feeds or medications.
- Notify your child’s school about the G- tube and provide safety information to the school nurse and teacher.
Help with Problems and Actions to Take
G-tube was pulled out
Try to replace the tube into the opening about 1-2 inches. Tape the tube to your child’s stomach. Do not use the tube. Then call your care team and come to either the doctor's office or emergency room. The G-tube needs to be put in as soon as possible within 1-4 hours so the tract will not close.
|Redness and irritation around the stomach, soreness and foul odor||May be caused by leakage or infection||
If you are using a dressing, make sure to keep it clean and dry. A small amount of drainage around the tube is normal. Continue routine care and contact your child's doctor. A skin barrier cream may be ordered at this time.Site may be infected if your child has a fever; redness or swelling that extends past the stoma or thick yellow green drainage at the site.
Leakage at site
Problem with how G-tube is held in place. G-tube is not secure.
Call your child's doctor or nurse. You may be instructed to add more water to the balloon port at this time. May need a dressing or protective cream.
Long tube – check that disc is at the mark designated for your child.
Button tube – should be able to fit a dime between the tube and the skin on your child’s stomach.
|Skin or excess tissue appears to be growing where the tube enters skin||Some children are more prone to this than others||
This is called granulation tissue.Call your child's care team to discuss treatment. It is normal for this tissue to bleed a little when bumped or irritated. This is not an emergency but is a concern and needs to be treated in a timely manner.
G-tube is clogged
Thick formulas or medication
Try to slowly push / pull 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 care team.