What is gastrostomy?
Gastrostomy is a surgical procedure that involves creating an opening in a patient’s stomach to allow a feeding tube to be inserted.
The tube is known as a gastrostomy tube or a G tube. Your child’s surgical team can use the tube to administer food and medicine if your child is unable to take anything by mouth. The tube can stay safely in place for as long as your child requires it.
Who gets a gastrostomy tube?
Your child’s physician may recommend a gastrostomy tube if they have any type of medical condition that makes it unsafe or uncomfortable for them to eat or take medicine by mouth.
Some of these conditions include:
- Congenital problems (present at birth) that affect their mouth, stomach, esophagus, or intestines
- Chronic lung disease
- Premature birth
- Esophagus abnormalities
- Short bowel syndrome
- Heart disease
- Failure to thrive (the inability to grow and gain weight normally)
- Disorders related to sucking or swallowing (due to injury, premature birth, or developmental delay)
- Severe challenges with taking medicine
When is surgery needed?
Your child’s physician will perform an exam to understand the underlying causes affecting their ability to eat or take medicine.
If they believe your child can benefit from a G tube placement, they will discuss those reasons with you.
In some cases, physicians will order tests before recommending a G-tube for a patient. The most common type of test is an X-ray, which they can use to take a closer look at the child’s upper gastrointestinal (GI) system.
What can I expect from surgery?
Before performing gastrostomy surgery, your child’s physician will provide you with detailed instructions on when they should stop eating and drinking.
After undergoing G-tube surgery, most children will begin to gain healthy weight now that they are receiving more of the necessary nutrients and medicine they need to grow.
Most children will stay in the hospital for one or two days after their surgery. To be cleared for discharge, they will need to be pain-free and be able to demonstrate that they can take food and fluids through their new G-tube.
At-home care is critical to ensuring your child’s gastrostomy procedure is successful in the long term. Before they can go home, the physician will explain how to care for the G-tube, how to administer food and medicine with it, and how to address common problems that may arise. You should receive most of your home-use equipment while you’re still in the hospital so you can learn how to use it. This includes the:
- Feeding pump
- Syringes
- Tubing
While each child is different, most require around two weeks of at-home care before they’re fully recovered and comfortable with their new routine. If possible, plan to take time off work during this time to be with your child and help them navigate this new normal.
Caring for the Gastrostomy Site
Always wash your hands before touching the gastrostomy site, using water and antimicrobial soap. Twice each day or on an as-needed basis, carefully clean the site with warm water. As you do, make sure to remove all dirt, grime, or crusted areas that may have formed on the skin surrounding the tube.
While you may use a washcloth to clean the area, some people prefer gauze or Q-tips instead. Pat the area dry completely. Do not start cleaning the site until your child has been home for at least one week. The incisions should not get wet during their initial healing time.
After five days, your child can take a shower or bath, if they can keep the site dry.
Following a New Diet
Your child’s physician will provide you with a customized feeding plan before you go home. There are details in the plan that describe the foods and liquids that are permitted to pass through the G-tube.
For instance, the only fluids that can travel through the tube include:
You can also administer liquid medications through the G-tube, as well as pills that have been crushed up and diluted with water. To keep the tube clean and sanitary, always remember to flush it with water before and after each feeding or medication.
School and Activities
In time, your child can go back to school and return to their pre-surgery activity level.
At first, they may find it most comfortable to lie on their back to sleep, but they can eventually lie on their stomach as long as the tube remains safely in place. Secure the G-tube carefully under their clothes to make sure it cannot accidentally get pulled out at night or during the day.
When your physician permits a return to school, tell your child’s teacher about their new G-tube. They should know what to do in the event of an emergency. If you didn’t receive one at the hospital, you can request a spare G-tube or a to-go kit so they can receive immediate treatment at school if an emergency occurs.