Gastrostomy

Most complications can be easily treated if they are found in time. Keeping an eye on the site and following your doctor’s orders will help reduce risks.

Medicine

During a gastrostomy, your child may need anesthesia or a sedative, medicines to prevent pain and help them relax and sleep through the procedure. A specialist will watch your child carefully to make sure they are doing well.

After the procedure, your child will take medicine for pain. The medicines may make your child feel nauseous or dizzy. Ask for help if your child needs to get out of bed to use the bathroom.

Feeding tube

After the tube is placed, it is important that it not move from its spot. Serious problems can occur if the tube moves. For example, the tube could:

• block the small intestine
• stretch the opening and let liquids in the stomach leak out
• cause granulation [GRAHN-yoo-LAY-shun] tissue
• come out completely

If the tube does come out, it needs to be put back in right away. After the tube has been put back in, your child may need x-ray imaging to make sure it is in the right spot. If it is not, the stomach may be pushed back and the tube can enter the abdominal cavity. The stomach contents can leak, which is dangerous for your child.

Granulation tissue happens because the body is trying to close the stoma. This tissue can be reddish or spongy, and it can bleed easily. If your child has too much granulation tissue, it will need to be taken off.

Other tube problems include clogs and damaged parts. You should flush the tube right after feeding before the formula can dry, and look at the tube and site closely to find cracks or leaks.

Most tubes are temporary, but some have to stay in for life. If a tube has been in place for a long time, the stoma may not fully close after the tube is gone. A simple surgical procedure can fix this hole.

Infection

It is also important to keep the tube site clean and dry. Each time you clean or dress the site, you must look at it closely. Your child is at risk for site infections and leaks. Leaks from the stomach can burn your child’s skin and break down tissue.

Unwashed hands can lead to infection. You and all visitors must wash your hands with mild soap that has no scent. Other soap might bother your child’s skin. Be sure to rinse all the soap away. Only people with training should touch the site and only when needed. Do not let other people touch the site.

Use only water that is clean enough to drink to rinse the tube site and to flush the tube.

One of the first signs of infection is a fever, so take your child’s temperature if they feel too warm or hot.

Other risks

• Some children will not be able to burp easily because of treatment. Ask the doctor if this might be a problem for your child.
• Do not mix medicine with food. Some medicine may not be given through the tube because of the risk of clogs.
• Your child may not tolerate some formula. If they have diarrhea or an upset stomach, your doctor may need to change the formula.
• Avoid cutting yourself, your child, or the tube by using only blunt (not pointy) scissors to cut tube dressing and tape.
• Your child may sleep on their stomach so long as the tube does not move.
• Your child may play and do other things so long as they do not hurt or put pressure on the tube site. No rough play or contact sports.

Your child needs food and water to live. Normal feeding requires food and drink to go from the mouth down the esophagus [ih-SOF-uh-giss] to the stomach. When your child cannot get the nutrition they need because of birth defects, reflux, brain damage, or other reasons, a gastrostomy that places a feeding tube can help.

A gastrostomy is a quick, simple procedure. Learning as much as you can about your child’s condition and this procedure may help you cope.

Ask about anything you don’t understand. You have a right to understand every word the doctor or nurse says about your child’s health and treatment. If something does not make sense, ask them to explain.

Before the procedure

To prepare, your child will need x-ray pictures so the surgeon knows what the area looks like.

Your child will not be allowed to eat or drink for a while before the procedure. This is to prepare their body for anesthesia or sedation.

Some questions you might want to ask your child’s doctor include:

• Will my child need antibiotics to prepare for surgery?
• When does my child need to stop eating and drinking?
• How is the surgery done?
• How long will it take?
• When can I see my child after it is done?
• Will my child have side effects from the anesthesia?
• How long will they need to stay in the hospital?

Before your child goes home?

Before you go home, find a convenient spot to keep your child’s gastrostomy supplies so you always know where to find them.

To help you prepare for taking your child home from the hospital, you can ask the doctor or nurse any questions you have. Here are some questions you might want to ask:

• How will I care for my child and their gastrostomy site?
• Where do I get the supplies I need to take care of my child?
• Will a nurse come to my home to help?
• What can go in the tube and what can’t?
• How often will my child need feeding through the tube?
• May my child also eat by mouth?
• How can I hide and protect the tube under my child’s clothing?
• What activities should my child avoid?
• How can I tell if the tube is blocked?
• What do I do if the tube comes out?

You may feel it is best not to tell your child too much about the surgery, or they may be too young to understand. If your child has questions you cannot answer, your doctor or nurse may be able to help.

Gastrostomy is a short procedure where an opening from the outside of your child’s belly to their stomach is made by a doctor. The opening (called a stoma) may be used to relieve pressure on the gastric system, or a feeding tube may be inserted into the stomach.

PEG

One kind of gastrostomy is called a percutaneous [PUHR-cue-TAY-nee-US] endoscopic gastrostomy (PEG). A PEG is done in an operating room by a surgeon. During a PEG, the surgeon uses an endoscope to find the best spot to put the feeding tube, which is called a PEG tube.

An endoscope is a tube with a light and camera, and it goes down your child’s mouth. Your child may need numbing spray in their mouth so they do not cough or gag, and they will wear a mouth guard to protect their teeth.

Your child’s midsection will be numbed before the procedure, and they may get medicine to help them relax. They will need stitches to close the skin around the tube.

Surgical Gastrostomy

During surgery, your child will be under anesthesia (ann-ess-TEE-see-uh), meaning they will be asleep and numb. The anesthesia will probably be given through a vein.

The surgeon will cut a small hole in your child’s belly to place the feeding tube, which is called a G-tube. Sometimes the surgeon will put in a temporary tube that will be changed out with a G-tube later.

Laparoscopy

The laparoscopic technique uses one or more small cuts and a tiny laparoscope [lap-er-uh-skohp] in the abdomen that the surgeon can look through. This technique can be combined with a PEG or open surgery.

You will be told if your child’s surgery or PEG was a success right after it is done. Other results, such as having your child gain needed weight, will take longer. Your child will visit the doctor regularly to track their weight and overall health. A nurse may also come to your home to help track your child’s progress.

Before you leave the hospital, your child’s first follow-up visit should be scheduled. Your child’s doctor will let you know how often you need to take your child in for a follow-up.

Because of the special diet of formula, your child’s weight and other measurements (such as sugar and water levels) may need to be checked regularly. The tube also needs to be checked to be sure it is in the right place and is in good condition.

You may also have the option of home care, where a nurse comes to your house to check on your child.

Gastrostomy [gah-STRAW-stuh-mee] is a short procedure where an opening from the outside of your child’s belly into their stomach is made by a doctor. The opening, called a stoma [stoh-muh], may be used to relieve pressure on the gastric system, or a feeding tube may be inserted into the stomach.

A feeding tube delivers liquids, liquid nutrition (formula), and medicine in liquid form directly to your child’s stomach. A feeding tube might be placed when your child cannot eat or when your child cannot get enough nutrition from what they eat and drink. A liquid diet through the feeding tube can give your child some or all of the nutrition they need.

Formula can be given slowly all the time, or feedings can be spaced out. Ask your child’s doctor if they can also be fed by mouth.