Understanding gastrostomy tubes: a parent’s perspective
(A gastrostomy may also be called a G-Tube, Gastrostomy Tube, Gastrostomy Button, PEG, PEG-Tube, G-Button, Bard, Mickey, Mini, Nutriport, or a host of other names)
Sam wasn’t eating enough to keep increasing his weight adequately for his height, so his doctors surgically poked a hole from inside his stomach out through his skin. That hole, or “stoma”, is basically like the hole formed when someone has their ear pierced: as long as the hole is kept open, our skin quickly heals new tissue around it to form a passage. Instead of an earring, the surgeon put a short, silicon feeding tube appliance through Sam’s new tummy-hole. This G-Button:
- Keeps the hole from closing (like an earring).
- Has a one-way valve (or button) on the outside which lets us add food formula directly into Sam’s stomach to supplement the food he eats and drinks himself.
How Sam’s G-Button Stays in Place; Normal Movement and Level of Cleanliness:
G-Buttons have been developed specifically for child patients to let them do everything their friends do. (With adult patients such a tube, or catheter, usually is continued outside the abdominal wall, taped in place, and just worn under their clothing.) As shown below (SEE DIAGRAM), G-Buttons are held firmly in place with pieces at either end of the short tube to keep it from moving in or out more than a small amount; the tube is also the permanent shaft through the actual hole in Sam’s tummy. (Think of a bolt that’s held in place by nuts at each end.) The outside holder, or external base, is a small silicon piece with the one-way feeding valve through it.
With Sam’s type of G-Button, instead of another solid disk the inside holding piece is a small silicon balloon which we keep inflated with about 6ml of water. This makes the G-button much easier to replace with a larger size as Sam’s tummy (and Sam) gets bigger. As a result, the outside part of Sam’s G-Button actually has two valves:
- The main, feeding valve in the center that’s covered with a protective cap.
- A second valve, pointing sideways, through which we keep the little balloon on the inside filled with water to hold the button in place.
This setup is very strong and durable. A little bit of the tube shaft showing (say 1/8th inch) is normal, as is some discolored skin right around the G-Button. Sam’s G-Button is *not* a sterile site it only needs the same level of cleanliness as a child’s mouth.
What to Do if Sam’s G-Button Gets Pulled Out (Which is Unlikely):
Wipe it off, put it back in (if he’ll let you), and hold it in place with an ace bandage around Sam’s middle. If balloon is still inflated, stick say a straightened paper clip into the inflation valve to let out the water. Once deflated, put tube back through hole and hold in place as above. Call Doug and/or Karen immediately.
The Goal: as with a pierced ear, keep the hole into Sam’s tummy from healing over!! It will start healing over *very* quickly (in less than 30 mins), and the more tissue that closes the hole, the more painful for Sam when we reinsert a new tube.
Information courtesy of Doug Ryan (Sam’s Dad).
For support in understanding feeding issues, go to https://www.feedingmatters.org/understanding-pediatric-feeding-struggles
For more general information and parent support, contact our friends at Feeding Matters https://www.feedingmatters.org/