What is a gastrostomy tube?
“Gastro” is a word used to describe the stomach. A gastrostomy tube, sometimes called a G-Tube, GT or PEG tube, is a surgically placed tube that gives direct access to your child's stomach for supplemental feeding, hydration or medication.
How is a G-tube placed?
A G-tube is placed through the belly opening and into the stomach. G-tubes are placed surgically in the operating room. The surgeon will make one or more small incisions in the belly area, then make an opening into the stomach called a stoma.
Preparing for G-tube surgery
You and your child will meet with one of the general surgeons at CHEO for an appointment before the G-tube surgery. At this appointment, we will explain the details of the procedure and you’ll have a chance to ask questions and address any concerns. Then we will schedule the procedure for a later date.
Right after surgery, all children and youth are admitted to CHEO for a few days to safely begin feedings. During this admission, we will help the parents learn how to care for the G-tube, administer feedings, clean and care for the stoma and apply a gauze dressing.
Follow-up after G-tube surgery
Your child will be seen for an appointment with a surgery team member about four to six weeks after being discharged from CHEO. Often, we will change the G-tube at this appointment. If needed, we will schedule additional follow-ups.
Types of G-tubes
There are many different types of gastrostomy tubes that can be used to help your child. The type of tube selected depends on each child or youth’s unique medical condition. Their doctor will determine the best type of G-tube for them and explain this in detail at the time of the evaluation. Here are some of the most common types of G-tubes to help you understand what to expect.
Percutaneous feeding tube
The word “percutaneous” means “to go through the skin.” A percutaneous feeding tube is placed through the abdominal wall into the stomach to allow feeding directly into the stomach or intestines.
There are two different types of percutaneous feeding tubes - one that goes into the stomach (called a gastrostomy tube or G-tube) or one that goes into the intestines (called a gastrojejunostomy tube,or GJ-tube)
The first tube your child will have is called a Dawson Cook Pigtail Catheter.
After 6 weeks the primary tube will be removed and changed to a low-profile button, which sits 1 to 2 centimeters off the skin. These tubes are inserted and removed more easily than the original one. They will be changed approximately every 3-6 months and changing them does not require sedation.
Low profile tubes
One of the most common types of G-tubes is a low-profile tube sometimes called a “button.” This type of tube lays on top of the abdominal wall and is kept in place in the stomach by a water-filled balloon. A special extension tube is attached when administering medications or feedings. During your child’s CHEO admission, you will learn how to use, clean and care for the G-tube.
The low profile button is a small skin level gastrostomy device made of silicone. It is non-latex. The side port has a valve to inflate a balloon, which anchors the device inside the stomach. The feeding port on the top has an external base to allow for the feeding of formula or water.
The low profile device replaces the original gastrostomy tube. Once your child’s stoma is healed, we can replace it with a low profile device (either a MIC-Key or ATM MiniOne). You will come to CHEO for an appointment, where your child’s stoma will be measured so we can properly size the low profile device for you.
Want to learn more? Find detailed instructions for taking care of gastrostomy tubes here.
Venting the G-tube
Gas may build up in your child’s stomach. Usual signs of gas in the stomach are bloating, crying or restlessness, especially after feeding. You can let gas pass out of the stomach through the gastrostomy tube. This is called “venting” the tube. Your child’s doctor may recommend that you vent the tube before, in between and after each feed. Venting is important especially if your child has had a fundoplication (anti reflux surgery).
For detailed instructions and steps, check out our guide to taking care of gastrostomy tubes.
Flushing the G-tube
Flushing the gastrostomy tube is an important step to keeping it clean and preventing blockages in the tube. You should clean it often by flushing water through it. If the gastrostomy tube is not flushed, formula sticks in it and blocks the tube. Flushing also gives extra fluid that your child needs. Always make sure to use sterile water for babies less than four months of age and check the flush amounts for young babies and children with fluid restrictions very carefully.
You should flush the tube:
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Before and after each feed.
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After venting the tube.
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Every 4 hours during continuous feeding.
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Before and after giving your child medicine through the gastrostomy tube.
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Once a day if tube not used.
Site care
When caring for your child or youth’s tube, it’s important to:
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Wash your hands first
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Gently wash the stoma and surrounding skin with mild non-lanolin based soap and water (e.g. Dove unscented), using a soft hand cloth. To clean directly around the tube, gently use a q-tip or non-sterile gauze.
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Rinse well with clear water and pat dry.
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Check the stoma and surrounding skin area for any irritation, redness, swelling, leaks, tissue growth or bleeding.
The type of dressing needed type of tube and the amount of drainage at the stoma site.
You will also need to:
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Change your child’s dressing when it gets wet.
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Make sure your child’s feeding tube is always taped securely to the skin to prevent it from moving or falling out.
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Change the place where you tape the gastrostomy tube to your child’s skin once a day.
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Keep an extra feeding tube with you at all times.
You may notice a small amount of yellow-green liquid drainage at the site. This is normal.