Some kids have medical problems that make it hard for them to get enough nutrition
by mouth. A gastrostomy tube (also called a G-tube) is a tube inserted
through the belly that brings nutrition directly to the stomach. It's one of the ways
doctors can make sure kids who have trouble eating get the fluid and calories they
need.
A surgeon puts in a G-tube during a short procedure called a gastrostomy. The G-tube
can stay in place for as long as a child needs it.
Kids who have had a gastrostomy (ga-STROSS-teh-mee) can get back to their normal
activities fairly quickly after they have healed.
Who Needs a G-Tube?
Kids need G-tubes for different kinds of health problems, including:
congenital (present at birth) problems of the mouth, esophagus, stomach, or intestines
sucking and swallowing disorders (due to premature
birth, injury, a developmental delay, or another condition)
failure to thrive
(when a child can't gain weight and grow normally)
extreme problems with taking medicines
What Happens Before G-Tube Placement?
Doctors often order several tests before a child can get a G-tube. The most common
test is an X-ray of
the upper gastrointestinal (GI) system. This lets the doctor see the upper part of
the digestive system.
Sometimes the surgeon asks the family to meet with specialists, such as a gastroenterologist,
dietitian, or social worker. This is to prepare a care plan so everything will be
set up when the child goes home with the G-tube.
To get ready for the procedure, you will need to carefully follow instructions
about when your child must stop eating and drinking. When you get to the hospital,
the doctor will describe what will happen and answer any questions. The anesthesiology
team will ask about your child's
and when your child last ate and drank.
Before the procedure begins, the care team sets up monitors to keep track of your
child's vital signs (like blood pressure and oxygen level) and puts in an intravenous
line (IV) to give medicines and anesthesia.
Your child will go to the operating room, and you'll go to a waiting area. A hospital
staff member will tell you when the procedure is over.
What Happens During G-Tube Placement?
There are three ways doctors can insert a G-tube. Sometimes a combination of methods
is used.
The laparoscopic
technique is done by making two small incisions (cuts) in the belly.
One is for inserting the G-tube, and the other is where the surgeon inserts a tiny
telescope called a laparoscope. The laparoscope helps the surgeon see the stomach
and other organs and guide the G-tube into place.
Open surgery is done with larger incisions. Surgeons choose this
method to guide the G-tube into place when other methods are not a good choice — for
example, if there is scar tissue from a past surgery or if the child needs another
surgery done at the same time.
The PEG procedure stands for percutaneous (through the skin)
endoscopic gastrostomy. The surgeon inserts an endoscope (a thin, flexible tube with
a tiny camera and light at the tip) through the mouth and into the stomach to guide
the G-tube into place.
How Long Does G-Tube Placement Take?
Putting in a G-tube takes only about 30 to 45 minutes.
What Happens After G-Tube Placement?
Kids usually stay in the hospital for 1 or 2 days. Most hospitals let a parent
stay with their child. While in the hospital, your child will get pain medicine as
needed.
The nurses will teach you how to:
Care for the tube and the skin around it to keep it clean and infection-free.
Handle potential problems, such as the tube accidentally falling out.
Give a feeding through the tube. You will also learn what to feed.
Help your child eat independently, if the doctor says it's OK.
By the time your child is ready to go home, you should have:
detailed instructions on home care, including bathing, dressing, physical activity,
giving medicines through the tube, and venting (releasing gas from) the tube
a visit scheduled with a home health care nurse to make sure things are going
smoothly
follow-up visits scheduled with your doctor to check the tube and your child's
weight
Are There Any Risks From G-Tube Placement?
All surgeries come with some risks. The surgical team will discuss them with you
before the procedure and do everything possible to minimize them. If you have any
concerns, be sure to bring them up before the procedure.
Complications of surgery can include:
extra tissue (granulation tissue) forming at the tube site
leaking
problems from anesthesia
bleeding
an allergic reaction
infection
Granulation tissue or leaking can usually be fixed by caring for the wound as instructed
or changing the feeding schedule. Sometimes surgery is needed to fix a problem at
the surgery site.
How Can Parents Help After G-Tube Placement?
It's normal to feel a little bit nervous about the G-tube at first, but it's important
that you feel comfortable taking care of it. Here are some tips:
Know what to expect as the G-tube heals. Talk to your child's care team if you
have questions.
Get support from other parents. It can help to connect with other parents whose
kids have G-tubes. Ask your child's doctor about a support group, or look online.
Talk with a social worker. Some kids with a G-tube worry about how the tube looks
and how others might react. If your child is concerned, ask your care team to recommend
a social worker who can help.
When Should I Call the Doctor?
Call your doctor if your child has any of these problems:
a dislodged tube
a blocked tube
any signs of infection (including redness, swelling, or warmth at the tube site;
discharge that's yellow, green, or foul-smelling; fever)
