A gastrostomy is immensely helpful in feeding individuals who have problems with ingesting or digesting food. This system includes a surgically made opening or stoma in the belly and a G-tube or a gastrostomy tube that has been placed directly into the stomach to deliver food and fluid. A balloon or plastic cap keeps the tube in place.
A gastrostomy is often recommended for persons with neurological or digestive disorders that require long-term management.
For successful feeding, the gastrostomy must be cared for properly, especially after the patient is well enough to stay at home. Below are important basics to understand regarding gastrostomy feedings.
Feeding and Tube Care
Depending on the condition of the patient, the tube can be used for food, fluids and/or for administering medicine.Photo via Pixabay
There are three different methods of feeding administration: bolus, continuous, or combination. A bolus is a specific amount of formula, often a large amount, given over a short period. Meanwhile, a continuous feed is done gradually over many hours and in small amounts through an electric pump. Combination enteral feeding is when a bolus feed is given during the day and a continuous one is administered at night.
A special liquid formula is prescribed to the patient and it contains complete nutrition. Remember to flush the tube before and after feeding or giving medication.
Also, always have a spare tube. If the inserted one falls out, replace it quickly to prevent the stoma from closing. Avoid infection and complications by replacing the feeding tube and accessories at the intervals specified by the manufacturer. Used tubes can go in the regular waste disposal.
Care of the Gastrostomy Site
Once the opening heals, clean it regularly. Use warm water and soap and gently wash the area twice a day or as needed, then dry thoroughly. Check the skin around the stoma and watch out for redness and other signs of infection. It can leak a little so make sure you always clean the area to avoid irritation.
The doctor will advise you when regular baths are safe again. Remember to close the G-tube before showering. Only use lukewarm water, mild soaps, and soft washcloths when washing the stoma site, and make sure not to rub it.
Some minor discomfort or inconvenience regarding the gastrostomy can be managed well at home. The most common of these problems is a blockage in the tube. This issue can be addressed by simply flushing the tube to clear the blockage. Stomach cramps can also occur. To avoid this, you may need to slow the rate of feeding and ensure the feed you are giving is at room temperature before administration.
If the stomach seems to be hard or swollen after feeding, help the patient vent or remove wind. You can also let air escape by attaching an empty syringe on the tube or by removing the clamp and opening the end of the G-tube. For vomiting problems, the feeding rate can also be slowed. Overfeeding and gas accumulation may cause this issue.
The tube eventually breaks down, too. The rubber will be harder to use or the outside end will split. Tube replacement is necessary to remedy these problems.
When to call a doctor
While minor problems can be managed at home, there are certain instances when you need to call a doctor or go to the hospital. If the patient experiences severe pain, especially from the administration of feed or medicine, notify the doctor immediately. Do the same if there is any bleeding on the gastrostomy site or when the feed or stomach contents continuously leak out. If you’re caring for children, it’s important to instruct them to tell you if they’re experiencing any of these signs. This way, you can seek medical attention as soon as possible.