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

Amy Long Carrera, MS, RD, CNSC, CWCMS
Registered Dietitian Nutritionist | Shield HealthCare
07/26/11  6:41 PM PST
G-Tube Care

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.

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.

 

For more helpful tips and resources about G-tube care:

Common Complications of Home Tube Feeding Webinar Video and Slides
Feeding Tube Site Care 101

Comments

20 Comments

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

    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. Posted February 10, 2015 at 9:03 pm PDT

    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. 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. 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. 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. 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 PDT

    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. Posted December 5, 2016 at 2:34 pm PDT

    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. 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. 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. 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. 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!

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