A gastrostomy is a direct opening through your belly (abdominal) wall into your stomach. A gastrostomy tube (sometimes called a PEG tube or G-tube) is passed through this opening. This allows you to get food and medicine without having to swallow. It's more comfortable and easier to use than a tube from the nose to the stomach. Gastrostomy tubes are used in short-term (temporary) or long-term (permanent) conditions where there is trouble swallowing. This includes stroke and cancer of the mouth, throat, or esophagus. It also includes radiation to the chest.
The most common way this type of feeding tube is inserted is during an endoscopy. This uses a lighted flexible tube called an endoscope. This scope helps guide the health care provider as they make a small opening through the skin of the upper belly (abdomen) and directly into the stomach. You are usually sedated with I.V. (intravenous) medicine for comfort. Once the feeding tube is placed, the scope is removed.
Feeding tubes generally last 6 to 12 months before they need to be replaced. Replacement is often easier than the initial insertion, since the opening is already there.
Home care
The following will help you care for yourself at home:
During the first weeks after insertion, do the following:
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Clean the area around the wound daily. Apply a topical antibiotic ointment only if advised by your health care provider. Cover the tube at the insertion site with gauze. Make sure the gauze is over the skin and tube, not between. The external bolster should not be tight on the skin. Instead, the tube should be able to move about ½ to ¾ inch and be turned. If not, it's too tight.
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Watch for redness, swelling, or pus coming from the opening in the skin.
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Watch for fluid leaking around the tube and report this to your provider.
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If the tube falls out, it must be put back in within 24 hours or the wound will close up.
Start feedings as instructed:
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Wash your hands with soap and clean, running water before preparing the formula or touching the feeding tube.
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The tube is narrow, so use only commercial feeding formulas. This will help make sure the tube won't get clogged. These formulas are designed to provide all the protein, carbohydrates, vitamins, and minerals needed. Follow your provider’s advice (or the registered dietitian or nurse who is working with you) about the number of feedings to give each day.
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Flush the tube with clear water before and after feedings or after medicine has been given through the tube. This is very important. Otherwise, the tube can become blocked. The amount of water will depend on your age, health, and specific situation. Follow your provider's instructions on how much water to use.
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When feeding, you should be upright or reclining at not less than 30 degrees to reduce the risk of the feeding solution draining incorrectly and causing aspiration into the lungs. Stay in this position for at least 30 minutes after the feeding.
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Infuse food slowly. It may take more than 1 hour for 1 feeding session.
Here are some other guidelines:
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If the tube gets blocked, flush with a syringe full of water.
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If you feel bloated after feeding, remove the cap from the end of the tube so that extra air in the stomach can flow out. Cough to help remove the extra air.
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Oral and dental care is needed, even if you're not taking any food or liquids by mouth. Brush your teeth and gums daily. Keep the lips moist with a lip balm or petroleum jelly.
Follow-up care
Follow up with your health care provider as advised.
Call 911
Call 911 if you have symptoms such as:
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Chest pain.
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Trouble breathing.
When to contact your doctor
Contact your health care provider or get medical care right away if any of these occur:
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The feeding tube falls out.
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The feeding tube gets blocked and you can't clear it.
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You have a fever of 100.4ºF (38ºC) or higher, or as directed by your provider.
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Your stomach contents leak around the tube onto the belly.
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You have belly pain or swelling that gets worse.
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There is redness, pus, or bleeding at the insertion site.
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You are vomiting tube feeds.
