Feeding tube placement

A feeding tube is placed through the abdominal wall into the stomach to allow feeding directly into the stomach or intestines. A tube feeding into the stomach is a gastrostomy tube, or G-tube. a tube feeding into the intestines is a gastrojejunostomy tube, or GJ-tube. 

The tube is secured in place with a small balloon.   The G tube has two ports – one for the stomach and one for the balloon. The GJ tube has three ports – one for the stomach (gastric port), one is for the intestine (jejunal port), and one is for the balloon.

Anesthesia

Patients receive IV sedation or general anesthesia.

Pain

Your child may experience discomfort around the tube for several days. We will give your child pain medicine to alleviate the tenderness.

Risks

This procedure is considered low-risk. However, complications may occur, including:

• tenderness or soreness at the site where the tube is placed
• bleeding
• infection
• injury to the esophagus, liver, spleen, colon or other organs, which may require additional procedures and/or surgery to repair
• peritonitis, a serious condition in which the lining of the abdominal cavity becomes inflamed

Aftercare

Your child will receive pain medicine and antibiotics to reduce the risk of infection. Tube feeds will be started after eight hours if there are no post-procedure symptoms. You will be shown how to care for your child's feeding tube. Your child won't have any stitches at the site of the tube. There will be a small piece of gauze between the tube and the skin.

A follow-up appointment will be scheduled with Interventional Radiology 10 days after the procedure to check the site.

Pain

Your child will probably have some pain or mild discomfort around the tube for several days.

Bathing

Your child may shower or take a sponge bath 48 hours after the procedure. It is very important that the area around the tube is not submerged in water for two weeks.

Restrictions

No contact sports or rough playing that might pull the tube.

Changing the tube

The tube should be routinely changed every three months and will be exchanged in radiology using live X-ray (fluoroscopy).

Skin care

You should look at the opening (stoma site) and surrounding skin once a day. A little drainage and redness at the opening is normal. Clean the stoma daily with unscented soap and dry the area well. Do not scrub the area, wipe it gently as this can cause skin breakdown.

Be sure to call your doctor or nurse practitioner if you see any of the following:

• A rash with red dots on the edges
• Increased redness or swelling around the stoma
• Open areas of skin around the stoma
• Bleeding from the stoma site
• Bleeding, painful or growing (granulation) tissue around the stoma
• Increased leakage at the stoma site
• Vomiting of formula when on "J" feeds
• Risks
• Loss of access
• Bleeding at the stoma
• Infection at the stoma
• Bowel perforation. This is very rare.

Clogged tube instructions

The intestinal portion of the tube can clog easily and, therefore, needs to be flushed with water throughout the day and after all feedings and medications administration. The stomach (gastric) portion should be flushed once a day.

If the tube becomes clogged, try flushing the tube. If you are unable to flush, please contact interventional radiology.  If your child cannot go without fluids, has a metabolic disease, or cannot skip a dose of medication (please check with your healthcare provider which medications cannot be skipped) then go to the emergency room until a replacement tube can be arranged.

Loss of tube

If the tube falls out, place the end of the old tube into the stoma approximately 2 inches and tape it into place. This will keep the stoma from closing.

DO NOT FEED through the tube and contact interventional radiology. If your child cannot go without fluids, has a metabolic disease, or cannot skip a dose of medication (please check with your healthcare provider which medications cannot be skipped) then go to the emergency room until a replacement GJ tube can be arranged.