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G-Tube Care: A Step-By-Step Guide

Amy Long Carrera, MS, RD, CNSC, CWCMS
Amy Long Carrera, MS, RD, CNSC, CWCMS
Registered Dietitian Nutritionist
07/26/11  6:41 PM PST

A step-by-step guide to checking, securing and cleaning your g-tube

Daily care and maintenance of your gastrostomy site and G-tube care are important parts of your tube feeding routine. Keeping the gastrostomy site clean and dry helps to guard against skin irritation and infections. Cleaning the tube will help it last longer.

STEP 1  G-tube care: How to check the gastrostomy site

Things to look for:

  • Skin redness (greater than 1/2 inch) around the tube
  • Drainage or leaking
  • Discomfort or pain around the tube*

*Increased redness, drainage or pain can mean the tube or internal or external bolsters are incorrectly positioned or secured. It may also mean an infection. This situation may require medical attention.

STEP 2 G-tube care: How to secure the g-tube

Tuck the tube gently into clothing. A tube that is left free to hang will pull on the gastrostomy tract. Over time this can injure the tract and the inside of the stomach.

Use tape on the tube, then pin through the tape tab to the inside of clothing.

Use paper, micropore or other tape that is not “gummy” to tape the tube to the skin or to a skin barrier dressing. (White adhesive tape will leave a sticky material on the tube and skin, which is harder to remove and may cause skin irritation).

STEP 3 G-tube care: Cleaning the gastrostomy site

You may need a clean wash cloth, cotton balls, cotton tip swab, mild soap, and warm water.

  • Wash hands well before and after cleaning the gastrostomy site.
  •  If dressings are used around the tube to cover the skin, these must be removed and discarded first.

Note: Sometimes a dressing is used around a gastrostomy tube for a few days after the tube is placed. After this, a dressing is not routinely needed. Should your tube require the use of a dressing, ask your doctor or nurse how to place dressing correctly.

  • Use half of a clean wash cloth or cotton balls to wash the skin around the tube with mild soap and warm water at least once daily. Clean anytime there is leakage around the tube. To avoid skin irritation and breakdown, the skin must be kept clean and dry.
  • Gently turn and rotate the external bolster to reach all areas of the skin. Be careful not to pull too hard on the tube and external bolster. This can harm the inside of the stomach.
  • Clean the tube with soap and water at this time also. A cotton tip swab may be used for hard-to-reach areas.
  • Rinse skin, then dry well with the other half of the clean wash cloth.
  • Starting on (date) you may clean the gastrostomy site during your regular bath or shower.

Note: For the first 4-6 weeks after placement of a new PEG, bath water should not be so deep that the tube is under the water. Shower water should fall on your back only.  For a balloon, low profile, or older PEG tube you can take a bath or shower as you normally do.

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DISCLAIMER: This information is designed for customer use only and does not represent the advice of a medical health professional. Please contact your doctor for explicit advice on your prescription and/or feeding program.

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Comments

32 Comments

  1. Maureen
    Posted February 9, 2015 at 3:31 am PST

    I had a Gtube placed in my abdomen 2 weeks ago I still have the stitches the sight is cleaned often I want to remove the stitches. it is uncomfortable.
    can you offer any advise?

  2. Amy Carrera, MS, RD, CNSC
    Posted February 10, 2015 at 9:03 pm PST

    Hi Maureen,

    Thank you for your question. I am sorry you are experiencing discomfort. My advice is to speak with your healthcare professional about the stitches.

    Thanks!
    Amy

  3. kaci
    Posted June 20, 2016 at 12:12 pm PDT

    how can i wrap up the hose to the gtube to bath him without it getting wet?

  4. Amy Carrera, MS, RD, CNSC
    Posted August 19, 2016 at 3:55 pm PDT

    Hi there, thank you for your question! You shouldn’t have to worry about getting the tubing of the gtube wet but if you’d like to keep it secured, you may find a useful product here: http://www.feedingtubeawareness.org/resources/useful-products/.

  5. Patricia
    Posted September 3, 2016 at 7:43 am PDT

    Do you apply the g-tube dressing under the bumper or over the bumper. I apply the dressing over the bumper to keep it secure, other nurses place the dressing under the bumper. Which is the correct way

  6. Amy Carrera, MS, RD, CNSC
    Posted September 7, 2016 at 8:54 am PDT

    Hi Patricia, thanks for your question! It depends on what you are using the dressing for. If it is to secure the tube, then placing it over the bumper should work. If you are using the dressing to absorb drainage, then it needs to go under the bumper. I hope this helps!

  7. Terry Anderson
    Posted September 7, 2016 at 10:33 am PDT

    After a Gastrostomy.tube is established, How often should the tube be changed

  8. Amy Carrera, MS, RD, CNSC
    Posted September 9, 2016 at 9:03 am PDT

    Hi Terry, thank you for your question! The answer depends on what type of tube you have. A standard tube with a solid internal bumper may last a year or longer. If the tube is held in place with a balloon that you have to fill with water, the tube should last 3 to 6 months. Sterile water is usually recommended to fill the balloon, as other liquids or air can leak from the balloon, causing the need for a premature tube change. Check the product insert that came with your feeding tube for specific instructions. If your tube looks discolored or is broken, check with your doctor to see if it needs to be changed. Hope that helps!

  9. jennifer
    Posted October 31, 2016 at 5:35 am PDT

    how often should you change the 60cc syringe used for bolus feedings? Also how often should the tube connector be changed.

  10. Amy Long Carrera, MS, RD, CNSC, CWCMS
    Posted October 31, 2016 at 2:33 pm PDT

    Hi Jennifer, thanks for your question! You should use a new feeding syringe every day. I’m not sure what you are referring to when you say connector – if it’s the extension set, it depends on how may are covered by your insurance plan, for example, CA state Medicaid usually covers 6 per month.

  11. Mary
    Posted November 30, 2016 at 7:50 pm PST

    What is the recommended time frame for use & reuse for daily irrigation kit of a G-Tube. Or how often should the syringe & piston be changed in a residential facility ? The irrigation supplies are only being used on 1 person.

    Thank you,
    Mary B. RN BSN

  12. Amy Long Carrera, MS, RD, CNSC, CWCMS
    Posted December 5, 2016 at 2:34 pm PST

    Hi Mary, thank you for your question! Instructions for use on enteral syringes may specify Single-use, Do Not Reuse or Replace every 24 hours. Although I have not seen a time frame specified as a clinical guideline, general practice is to use a new syringe every day.

  13. James
    Posted August 24, 2017 at 7:23 pm PDT

    How do I clean the first port on the g tube?

  14. Amy Long Carrera, MS, RD, CNSC, CWCMS
    Posted August 25, 2017 at 3:25 pm PDT

    Great question! In addition to regular flushing of the tube with water, you can clean the feeding and medication ports with a cotton tip applicator.

  15. Rhea
    Posted September 12, 2017 at 12:38 am PDT

    Hi my patient g tube 6days after insertion around the g tube red I clean every day his g tube but stil red what can I do to make dheal his wound?thanks

  16. Amy Long Carrera, MS, RD, CNSC, CWCMS
    Posted September 12, 2017 at 8:07 am PDT

    Hi Rhea, the site may be red because it’s still new but it’s possible that the tube might fit too tight or too loose. Can you fit the width of a dime between the skin and the external bolster (the part of the tube that sits on the skin)? If the tube has a balloon you can check to make sure it contains the right amount of water – too much and the tube may be too tight, too little and the tube may be too loose and move around too much on the skin, causing irritation. Other than that, continue to keep the site clean and dry and if the skin still doesn’t look right after a few more days call the nurse or doctor where the tube was placed. Hope that helps!

  17. Rhea
    Posted September 14, 2017 at 1:12 am PDT

    Thanks for advice.,I just want to ask again what is the formula feeding of g tube?its same in ngt tube also?? Or different thanks

  18. Amy Long Carrera, MS, RD, CNSC, CWCMS
    Posted September 18, 2017 at 1:36 pm PDT

    For the most part, the same formulas can be used in either a Gtube or NG tube. Some formulas, such as those that are more concentrated and contain fiber may be too thick to run through a smaller NG tube. Manufacturers will usually provide recommended minimum Fr size of tubing for each formula. Thank you for your question!

  19. Sherry
    Posted September 19, 2017 at 10:05 am PDT

    My g tube is clogged What can I use other than water to clean and unstop tube?

  20. Amy Long Carrera, MS, RD, CNSC, CWCMS
    Posted September 19, 2017 at 12:21 pm PDT

    Hi Sherry, sorry you are having trouble. Warm water is the recommended liquid to use. You may need to let it sit in the tube for a while and you may need to try a few times. Other liquids, such as juice or soda have been shown to be ineffective and have the potential to make the clog worse. Your Gastroenterologist may have an in-office method available. If your tube clogs often or is smaller bore/Fr size, it might be worth it to look into having the Clog Zapper handy. Hope that helps!

  21. Martha
    Posted September 27, 2017 at 7:34 pm PDT

    Hi my dad has had a G-tube in his stomach for about a month now and he is eating by mouth the doctor recomended keeping it in for a few weeks after eating regular food by mouth. We are taking care of it at home but recently noticed one side of the spot where the tube is in looks red and a little bit bloody. But the other side is fine not red and looks normal. We clean it everyday with water. Is this something we should be alarmed about?

  22. Amy Long Carrera, MS, RD, CNSC, CWCMS
    Posted September 28, 2017 at 4:24 pm PDT

    Hi Martha,
    Just to be on the safe side, I would suggest you get a hold of his healthcare provider and describe it to them. They may want to take a look at it. Thank you!

  23. Phuvan
    Posted February 27, 2018 at 8:14 am PST

    Hi can the first connecter which is the y-shaped where the syringe is fixed be removed for washing because it seems to be detachable.

  24. Amy Long Carrera, MS, RD, CNSC, CWCMS
    Posted February 27, 2018 at 2:08 pm PST

    Hi there, what kind of tube do you have? It looks like you might be in the UK. You may have something different than what we use in the states but if you provide more info I may be able to answer your question. If you’d like to email me directly at rd@shieldhealthcare.com that might be easier, Thank you!

  25. hemanth
    Posted August 28, 2018 at 9:11 pm PDT

    Dear sir my grandfather has been peg inserted 15 days over there is a formation of pus takes place wt are the precautions i have to take care please tell me sir

  26. Amy Long Carrera, MS, RD, CNSC, CWCMS
    Posted August 29, 2018 at 10:14 am PDT

    Hello, thank you for your question! Sounds like you should reach out to his nurse or doctor to take a look at it. There may be an infection or leakage around the site.

  27. Sue Jones
    Posted September 13, 2018 at 10:18 am PDT

    I am fed TPN through my PICC line but have a G-TUBE for meds & fluids I want to take. My skin around the stoma is open therefore anything that drains out my G-TUBE causes excruciating burning pain. The fluid constantly leaks around the tube. I have been using Desitin and Geer’s ointment. What would work better to heal this open area? I am scheduled to have G-TUBE replaced next week.

  28. Amy Long Carrera, MS, RD, CNSC, CWCMS
    Posted September 13, 2018 at 11:53 am PDT

    Hi Sue, thanks for reaching out! This sounds like a question for your wound care nurse. You should also find out if it’s a good idea to keep slit gauze or a washable gtube pad under the external bolster of your tube. Good that you are taking action and getting the tube replaced. Keep in mind that there should be about the width of a dime between the external bolster and your skin. If your tube has a balloon, you may need to check the amount of sterile water (air or other liquids can damage the balloon or make it unstable) in the balloon to make sure the tube fits properly. Here’s another resource: A Prevention Guide to Common Tube-Feeding Skin Care Issues. Hope that helps a little!

  29. Eva B.
    Posted May 30, 2020 at 11:43 am PDT

    How do you keep the inside the j peg from turning a lite brown ?

  30. Sarah Sanchez, NDTR
    Posted June 10, 2020 at 8:51 am PDT

    Hi Eva. That’s a great question! It turns out that it is normal and unavoidable for the feeding tube to turn light brown.
    Thank you for reaching out,
    Sarah

  31. Betty N.
    Posted August 13, 2020 at 8:58 am PDT

    If feeding tube has been in for 7 months and has not been used for a couple months, should it be removed? It is black inside and patient has had some UTI’s. Is this related? Thanks.

  32. Sarah Sanchez, NDTR
    Posted August 13, 2020 at 10:23 am PDT

    Hi Betty.

    We suggest getting in contact with the patient’s doctor as soon as possible. They will be able to determine if this is connected to the reoccurring UTIs and if the tube needs to be removed.

    We wish you both the best.
    Sarah

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