FAQs

Food, liquids, and crushed medications are given through the tube and into the stomach through the feeding and medication port. When not in use, the port should be capped off with the attached cover. An anti-reflux valve inside helps stop stomach contents from leaking out of the tube. The valve is opened when in use.

Low-profile G Tubes need an extension set to open the valves to give nutrition, liquids, and medicine.

The balloon should be filled with distilled or sterile water. Saline and tap water are not recommended as they may damage the balloon. Air is also not recommended for inflation. The balloon volume should be checked weekly and additional water should be added if the amount in the balloon is less than the amount prescribed by the healthcare team. An underfilled balloon could cause the tube to fall out. Check the IFU for recommended fill volumes as they vary by tube size.

CAUTION: USE CARE WHILE FILLING OR REMOVING WATER FROM THE BALLOON. BE SURE TO STABILIZE THE FEEDING TUBE IN THE STOMA AS IT MAY BE EASILY PULLED OR FALL OUT WHEN THE BALLOON IS DEFLATED.

A small syringe with a tiny tip is included with the G Tube kit to fill or empty the balloon and to replace the tube. This syringe attaches only to the balloon port of the tube. A larger syringe with a catheter or ENFit tip is used for connecting to the extension sets.

1. Wash hands with soap and water, then dry before touching the tube.
2. Keep the skin clean and dry. Bacteria loves warm and damp places which could cause an infection.
3. Gently clean the skin around the stoma using soap and warm water using cotton-tip applicators or a soft cloth. Then, rinse and dry well. Avoid scrubbing the site and using special cleaning products. This can cause redness or soreness on the skin.
4. Use a dressing if there is some drainage. Change it if it is wet or dirty.
5. Every day, look at the tube to make sure it is healthy.
6. Gently spin the tube once a day. Rotate the bolster 360◦ plus a quarter turn. This will avoid the tube from sticking to the skin. Do not rotate jejunal tubes as they extend into the jejunum and rotating may cause them to move out of place.
7. Gently clean the tube with a cotton-tip applicator or soft cloth.
8. Keep the balloon and feeding ports clean and clear of any debris. Caution: Do not push cotton-tipped applicators or other foreign objects through the feeding port valve as this may cause the valve to tear and leak.
9. Keep the tube secured so it does not wiggle, pull, or lean.
10. Flush the feeding tube with water every 4-6 hours during continuous feeding, before and after every bolus feeding. If the tube is not being used, flush at least every 8 hours.

Before feeding, check the G tube to be sure it is not clogged or has moved outside of the stomach. You may do this by drawing 5-10 ml of air into a syringe. Place a stethoscope on the left side of the abdomen just above the waist. Inject the air into the extension set feeding port and listen for the stomach to “growl.” Try again if you do not hear the sound. If you still do not hear it, do not give anything through the tube. Contact your healthcare team.

Another way to check tube placement is to connect the extension set to the feeding tube. Then, attach a syringe with 10 ml of water to the extension set feeding port. Pull back on the plunger. When stomach contents appear in the tube, flush the tube with water.

Check for leaking around the stoma. If you think the feeding tube has become dislodged, stop feeding and contact your healthcare team.

There are closed enteral decompression systems intended to allow extra gas to be removed from your stomach (gastric distention/bloating). It also prevents the loss of formula/nutrition, medicine, and stomach contents. While venting, any formula/nutrition that goes into the decompression bag and tubing must be gravity fed back into the patient. The roller clamp helps control the speed at which the formula/nutrition is fed into the patient. The decompression system can be used with neonates, pediatrics, and adult patients. For details on how to use a decompression system, check out the patient care guide or video.

Best to use liquid medicine because pills often clog the tube. If a liquid form of the medicine is not available, use a pill crusher to make a powder. Then mix the powder with water before putting it through the tube. Check with the pharmacist if it is ok to crush the pill. Medicine should not be mixed with formula as they may harden together and cause a clog in the tube. Never crush enteric-coated medication.

Always flush the tube with water before and between each medicine. This is because some medicine may react with each other. Flushing the tube prevents clogging.

Leakage may happen for several reasons:

• You may be feeding too fast or feeding too large a volume. Always consult with your healthcare team before making any changes to your feeding plan.
• Your balloon may not have enough water. Weekly balloon volume checks can help make sure you have the correct amount. Your balloon may be leaking if you notice the fluid volume is often below the prescribed amount. If the balloon does have a leak, the tube will need to be replaced.
• The tube length may be too long. Your healthcare team can help you get the right length tube.
• The tube may be not stable which can cause it to wiggle or pull. Talk with your healthcare team on ways to help with this.

CAUTION: USE CARE WHILE FILLING OR REMOVING WATER FROM THE BALLOON. THE FEEDING TUBE MAY FALL OUT or BE EASILY PULLED OUT.

If you suspect gastric leakage:

• Gently clean and dry the site. After 30 minutes, check the site to see if there is any fresh leakage. This is a way that will let you know if there is actual gastric leakage and not just spillage from a previous feeding or tube check. If there is actual gastric leakage and the skin is intact, you may ask your healthcare team whether you should apply a skin protectant or moisture barrier such as zinc oxide ointment. Notify the healthcare team if skin redness is more than 1 cm from the stoma or if there is pain, swelling or removed skin.

The standard-length G Tube is used for giving nourishment, liquids, and medicine into the stomach. It may also be used to get rid of extra air or contents from the stomach.

The standard-length G Tube is made of silicone. It has a balloon on the inside that keeps the tube from falling out of the stomach. It also has a ring or disc on the outside that rests gently on the skin which keeps the tube from moving around. The tube should be capped when not in use.

The GJ Tube is used for giving nourishment, liquids, and medicine into the small intestine (jejunum is part of the small intestine). The tube goes through the stomach and into the jejunum. The jejunal feeding port is used for giving feedings and medicine. The GJ tube is made of silicone.

This tube also can be used for decompression which is a way to get rid of extra gas in the stomach. The gastric port is used for decompression or medicine (only if advised by your healthcare team).

Standard-length GJ Tubes have a ring or disc on the outside that rests gently on the skin which keeps the tube from moving around. The tube should be capped when not in use.

Low-profile GJ Tubes need an extension set to open the valves to give nutrition, liquids, and medicine.

The J Tube is used for giving nourishment, liquids, and medicine into the small intestine (jejunum is part of the small intestine). The tube goes through the stomach and into the jejunum. The jejunal feeding port is used for giving feedings and medicine.

The J Tube is made of silicone. Standard-length J Tubes have a ring or disc on the outside that rests gently on the skin which keeps the tube from moving around. The tube should be capped when not in use.

Low-profile J Tubes need an extension set to open the valves to give nutrition, liquids, and medicine.

Once the site is healed, most people can bath or shower. Talk with your healthcare team about when you should start bathing and showering.

Always check that the cover on the tube is closed tightly or the tube is clamped.

It is important to flush the tube before and after each use. The tube should also be flushed every 4 hours, even during feedings. Here are some reasons for flushing:

• Helps push all the food or medicine through the tube.
• Stops the tube from clogging. Sometimes the amount of water used to flush may be smaller or larger.

It is important to check that the tube is in the right place each time before using the tube. This can be done by drawing a pen mark on the tube at the point where it enters the nose. This will make it easier to see if the tube has moved out of place. Someone will teach you how to do this and care for the tube.

If you are told you can change the tube at home, you will be taught how to do this. It is easier if you do this in front of the mirror.