Enteral Tube Program
Troubleshooting Common Gastrostomy (G-tube) Concerns
What should I do if my g-tube is leaking?
Leaking (sometimes called drainage) around a g-tube site can be a common problem. Leaking is often caused by a g-tube that does not fit the right way or has a balloon that is not filled with enough water. Mild crusting or clear drainage without any other signs of infection (see below) may be normal after a g-tube placement or change.
If your child’s g-tube is leaking, make sure the g-tube is secure and stable. For more information, see the home care instructions for your g-tube.
If the tube is stable and the leakage continues, gets worse, looks like blood or pus, or is coming out from a crack in the tube, please call your child’s GI doctor right away.
What is granulation tissue?
Granulation tissue is extra pink tissue that can often grow around the g-tube site (Figure 1). It happens when there is too much friction (rubbing) around the g-tube site. Some children are more likely to have granulation tissue develop. To lower the risk of granulation tissue, make sure your child’s g-tube is secure. For more information, see the home care instructions for your g-tube.
In some cases, granulation tissue may cause a small amount of bleeding, leaking, or irritation around the g-tube site. Usually granulation tissue can be treated with a steroid ointment or silver nitrate that is put on by a doctor or nurse in the clinic. In rare cases, granulation tissue may need treatment by a general surgeon. Please tell your GI doctor if you think your child may have granulation tissue.
How can I tell if my child’s g-tube is infected?
Skin infections occur when normal germs that live on the skin or in the environment break into the tissues under the skin (Figure 2). Some children can get skin infections around their g-tube.
Call your GI doctor right away if your child has ANY of these signs of infection:
- redness around the g-tube site that spreads out past the area right around the stoma insertion site
- swelling around the g-tube
- warmth or soreness at the g-tube site
- unexplained fevers
- white or yellow drainage coming from the g-tube site
G-tube infections can often be treated with antibiotics which can be given either by mouth or put through the g-tube. In severe cases, antibiotics may need to be given through an IV. Please call your child’s GI doctor if you think your child has a skin infection at the g-tube site.
What should I do if the g-tube is clogged?
Slowly flush the g-tube with 5-10 ml of warm water. Roll the g-tube between your fingers to break up anything clogged in the tube. Do not try to push an object into the g-tube to unclog it. Do not use carbonated beverages, cranberry juice or other “sticky” syrup based products to try to unclog the g-tube. These products can make the clogging worse.
If the g-tube is able to be flushed, you can continue to use the tube. Always remember to flush the g-tube before and after use to prevent the g-tube from clogging.
If you are not able to flush the g-tube, call your GI doctor or the GI doctor on-call.
Who can I call if I have questions?
Please call the GI office (617) 355-6058 if you have questions or concerns. Our GI nurses can help you with all types of PEG tube questions:
- Monday–Friday, 8:00am–4:30pm, a nurse in the GI clinic will be available to help you.
- Weekdays after 4:30pm, Weekends, and Holidays, you can use the same number to reach a GI doctor on-call for urgent questions or emergencies.
If your child is followed by General Surgery:
Call the General Surgery outpatient nurses at (617) 355-7716 or (617) 355-7704.
- Monday–Friday, 8:30am–5:00pm
Call the Children’s Hospital page operator at (617) 355-6369 and ask for the General Surgery Senior Resident on-call.
- Weeknights, 5:00pm–8:30am, Weekends, or Holidays