A gastrostomy is a surgically created opening in the stomach. A gastrostomy is needed if:
Gastrostomy surgery is usually done under a general anesthetic. This means your child will be asleep during the surgery.
A G-tube, is placed in the stomach to help with feeding or venting of stomach gas. There are 2 main types of G-tubes that are placed into the stomach:
Talk to your healthcare provider to find out which kind of tube is best for your child.
Your medical care team will teach you what you need to know to feel safe and comfortable taking care of the gastrostomy at home.
The end of the G-tube needs to stay snug against the inside wall of the stomach. The G-tube should be about 12.5 to 13 inches long from the exit site on the stomach to the end of the tube. It is important that you know the length of your child's tube. When your child's G-tube is snug against the stomach wall and correctly in place, use permanent ink to mark the tube at the spot the tube comes out of the stomach. That way you easily check if the tube is correctly in place by looking for the mark.
There are several ways to secure the G-tube to the skin on the stomach. A good way is to place a cotton roll (like the dentist uses in your mouth) on either side of the G-tube and tape the tube to the skin. Talk to your healthcare provider about any other specific instructions for taping down the G-tube.
Check daily to make sure that the end of the G-tube is in place by gently pulling on the tube until you feel resistance. Then tape the tube down securely.
Your healthcare provider will tell you when it is safe for your child to start taking baths or showers again. When your child is able to take a bath, remember:
Infants and children with a gastrostomy can participate in all normal activities such as crawling, walking, jumping, and swimming. Make certain the G-tube is carefully secured under clothing. A cummerbund (or girdle) made of cloth or BandNet (an elastic, netlike material) can help to secure the G-tube.
A G-tube should not keep your child from lying on his stomach. If your child complains that it hurts, you can put a foam doughnut around the G-tube site to keep pressure off the stomach.
Overalls, "onesies," or sleepers are helpful for young children who might try to pull out the tube. Clothing helps protect the gastrostomy site. Older children do not need any special kind of clothing.
When your child goes to school, make sure that your child's teacher and school nurse know about your child's gastrostomy. Let them know what to do and who to call in an emergency.
Your child can travel with a G-tube, as long as he or she has a travel kit of emergency supplies. The travel kit should include:
To keep stomach contents from leaking onto skin, gently pull on the G-tube so that the tube is snug against the inside stomach wall. Leaking from a button may be caused by valve problems or a broken balloon used for holding the tube in place. Call your healthcare provider if leaking continues.
Food or medicine may build up in the tube or body fluids may crust around the opening and block the tube. Flush the tube with 10 ml of warm water to clear any blockage. If the tube still seems blocked, call your healthcare provider.
Some drainage around the gastrostomy is normal, especially soon after the gastrostomy is put in. Clean the skin around it often. Make sure you remove all crusted areas from the tube itself. This helps prevent infection.
A small amount of red, moist tissue may grow around the gastrostomy. This is called granulation tissue. This is normal. If the there is a lot of tissue, the area becomes sore, or the tissue interferes with care, call your healthcare provider.
Vomiting and diarrhea may be caused by the tube moving into the stomach and blocking the stomach outlet. Measure the length of the G-tube daily from the exit site on the stomach to the end of the tube. Compare this number with the measurement you made earlier. If the tube is shorter, gently pull on the G-tube to make sure that the balloon is snug against the inside of the stomach wall. If you are not able to gently pull the G-tube and secure it into position, call your healthcare provider.
Gas and overfeeding can cause bloating of the stomach and retching. If this happens, unclamp the G-tube or open the button. This allows air to escape and relieves the problem.
Most tubes will last for 3 to 6 months, if your child needs one for that long. Over time, the rubber tube breaks down and gets harder to use. Many times the end used to add the feeding formula breaks off or splits. These are signs that the tube needs to be replaced.
If your child needs to go to the hospital or the emergency room, take your emergency kit and feeding supplies with you. If the gastrostomy tube or button has accidentally been pulled out, bring it with you.
Call your child’s healthcare provider if your child: