Ask the RD: What Causes G-Tube Pain?

Amy Long Carrera, MS, RD, CNSC, CWCMS
Registered Dietitian Nutritionist
04/11/14  8:10 PM PST
G-Tube Pain

Question: My tube-fed patient complains of G-tube pain — internal pain where his G-tube is located. What could be causing this?

Answer: If you’ve already ruled out abdominal bloating or constipation, pain may indicate the presence of infection or pressure necrosis on the inside of the body. Buried bumper syndrome occurs when the internal bumper becomes lodged into the gastric or abdominal wall, usually because of excessive tension between the internal and external bolsters. This phenomenon can happen when a patient gains weight, increasing his abdominal girth, and should be ruled out or confirmed by a gastroenterologist.

This article is designed for educational use only and does not replace the advice of a medical professional. For more information, please contact your primary care physician.

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37 comments

  1. Patient complaint of pain at peg site..no fever..but can’t defecate w/out dulcolax..that is y we give dulcolax every other day..she complaint pain once a wek..the stoma is clean & dry..that is y i want to know what are the other reason y a patient w/ peg tube complaining of pain..thanks..

    1. Thank you for your question. Would consider, is patient stooling regularly and are the stools soft or hard? Is the patient getting enough water? Fiber in the formula? Adequate water and fiber could help with bowel movements. If you can’t see any skin issues, PEG fits properly (about the width of a dime between external bolster and skin), no leakage, abdomen is not distended, no nausea/vomiting/constipation is noted, stools are soft and regular and pt is meeting fluid and fiber needs, may need abdominal xray to determine other causes, such as tube dislodgement or GI issues. If you would like to email em directly to discuss patient’s fluid and fiber needs, please do so at rd@shieldhealthcare.com. Thank you!

  2. Have a 31 year old daughter with cerebral palsy. She gets congested and mucus this time of the year (winter). She doesn’t feel well but no fever, vomiting but not too much ( mostly a lot of mucus). Giving her Pedialyte through her feeding tube and just her required seizure medication. No formula right now since she will probably vomit that up. Each time I give her the Pedialyte and her meds through the feeding tube she gets fussy and starts to moan. She is non-verbal so she is unable to tell me exactly what is going on. I plan to get her a chest x-ray to make sure there is nothing going on with her lungs. She had lab work done about 1-2 weeks ago and the Doctor did not inform me of any issues with her lab. She seems to have difficulty breathing towards the evening but not severe. I give her breathing treatments. Could she have a stomach ache, virus or UTI?

  3. I have a 13 month old who is on continuous feeds. He has congenital heart disease and other issues. He has chronic constipation. He takes aspirin daily. His gtube has always been sensitive. He gets cellulitis easily. If you pick him up under his arms he screams in pain, if you adjust his gtube button or place the extension he screams, he has even gone into a seizure when his gtube was pulled a little. His doctors just say he is sensitive. His stools are never regular, he either has extremely hard or extremely loose. They refuse to rule out anything on the inside that could be wrong. What do you think is wrong?

  4. Hi, my boyfriend is 60 and has ALS, the aggressive kind. He always thought he could beat this desease, and wanted to eat as this was one of his favorite things to do. He was up for a stem cell, but with low lung capacity, he is no longer a candidate. As we noticed he was choking and aspirating, he needed to get a G-tube, and did so. Within two days following, he got worse and wasn’t able to breath because of the heavy secretions. Every five minutes we ( nurse, RT, and I) were suctioning him. I was so exhausted. He developed diahrrea, while having heavy diarrhea and I guess we were putting more focus on his airway. Eventually he told us that ever since he got the G-Tube, the abdominal pains never left, and I wonder, will this part of his symptoms ever get better?

    1. Hi Irma, thanks for reaching out. I’m sorry he’s having trouble. Sounds like you should speak with his pulmonologist and gastroenterologist. Some things to consider, the rate of feeding – is he on a feeding pump or does he need one?, the type of formula he’s on – does it have fiber? does he have any issues with absorption?, is/was there an infection contributing to the diarrhea and increased secretions?, is he getting enough water through his tube to thin the secretions if needed?, does he generally have regular bowel movements and if not, does he need to be on a bowel regimen? Together with his medical team you should be able to get him more comfortable. Hope that helps!

  5. Hello, my patient has been on vacation for 3 weeks and when he returned, his jtube could not be unclogged. I have tried using warm water but no luck. Few days ago he started vomiting and having diarrhea, and stomach pain. Is there anyway to unclog this tubing. Could the stomach pain be related to the clogged tubing? Please advise on steps to take.

    1. Hello and thank you for your question. The stomach pain, vomiting and diarrhea could be related to a number of things, including possible infection. He should definitely be seen by his healthcare professional. If the tube has been clogged for a few days, which it sounds like is the case, you likely need to go in to see a professional and if it cannot be unclogged it will need to be replaced.

  6. Hi my Daughter is 30 years old with cerebral palsy she has been complaining lately about a lot of pain in her PEG area . The area around the site seems to be harder than usual. Unfortunately she cannot tell me what is going on , but is scared every time I go to touch it (ie for cleaning etc) and she is shaking her head when I feed her . Sitting in her wheelchair she seems to be really uncomfortable . She does have trouble doing a bowel movement but this is normal for her and is on medication for it , Was wondering if this is normal or worth insisting GP books up for us to go for an x ray

  7. Hi my grandson has a gtube an today for the first time ever has been saying his tuby hurts an points to it. He has had for about 2 1/2 years an never has he said this before. Any suggestions on what it could be? Thank you

    1. Hi Kathy. Thank you for your question. We hope that your grandson was taken to see his doctor to discuss any g-tube pain that can’t be explained by gas or constipation. Also, there is always the chance that stomach pains could be due to something as simple as a stomach bug going around at school. But any time there is pain, when it comes to a g-tube the person should always be taken to see a healthcare professional to diagnose the issue. We hope that helps. -Aimee, Shield HealthCare

  8. Hey Amy. I am a 59 year old female with Diffuse Systemic Scleroderma. In late August I had fundopplication surgery with a g-tube inserted. The tube subsequently fell out and a new one was put in, as a fresh start, 12 days ago. The pain in the area surrounding the site has been increasingly painful. Should I be seeking medical attention?

    1. Hi Lynn. Thank you for your comment, and sorry for the delay in our response. We would absolutely recommend seeking medical attention, and we hope that you did so shortly after you made your comment. We hope your issue was cleared up and that you are doing well. Thank you. -Aimee, Shield HealthCare

  9. Having a problem with my daughter ‘s peg tube. Got the tube almost 2 years ago due to oral cancer. Pain around site, pus and some redness, looks like muscles are pulling around site.tube has been changed 3 times. My daughter has gained about 15 pounds since she received the peg. Giving pain meds and antibiotics. What should I do. Thanks.

    1. Hi Dorthy. Thank you for you comment. The first thing we would recommend would be for your daughter to be taken to see a doctor. Any type of g-tube pain should be investigated by a healthcare professional. The pain and pus and the redness may indicate an infection. We spoke with a couple of our registered dietitians and they let us know that in regards to the 15 pound weight gain, the feeding regimen can be reevaluated by the RD or MD based on your daughter’s anthropometrics. In addition, that weight gain might be the reason for the muscles looking like they’re pulling around the site. We would also recommend checking out our Feeding Tube Guide that we offer for free, in a digital format. In there, we discuss skin integrity at the g-tube site. We hope those answers help and that you’re able to resolve the problem quickly. Best of luck. -Aimee, Shield HealthCare

    1. Hi Sandy.

      That’s a great question! According to the Mic-key website your specialist will determine how long your g-tube will last. It is our advice to contact them right away. This is the Mic-key website, for your reference.

      I hope this is helpful.

      -Sarah at Shield HealthCare

  10. In 54, female. had 2 cancers. Lung they took half left lower lube in June. Then base of tongue, I lost all swallow, had ng tube 6 weeks, Aug 18th had j tube put in at base rib cage right in middle of chest. So 5 weeks in having severe pain everytime I move. It actually brings tears. A lil redness but from button rubbing I sit up. No blockage

    1. Hi Sylvia. I am so sorry to hear about everything that is going on. With this severe pain it is important that you contact your medical team as soon as possible for an exam. This will help determine why you are experiencing this pain. – Sarah, Shield HealthCare

  11. My daughter-in-law has G and J tubes. She has pain around her J tube which the doctors have said is due to muscle spasms. She has a prescription for Dicetel but it doesn’t seem to do anything. She was also given a prescription for Tylenol 3 which temporarily takes the edge off. What else can she do to minimize this pain? Will this pain eventually go away? Or is this a matter of her having to “suck it up” – which doesn’t really appeal to any of us. Living with constant pain isn’t fun. She had the tubes inserted in May 2019. Thank you.

    1. Hi Dianne. Thank you for reaching out with your question. We are sorry to hear that your daughter-in-law is experiencing this pain.

      The tubes whether they’re G or J tubes shouldn’t be painful around the site. Both tubes are generally inserted around the same place on the abdomen and it’s the inside portion that is different. Pain could be from the tube being too tight/short or possibly an infection. We suggest seeking a second opinion if the pain persists. I hope this helps and wish you and your family the best.

      -Sarah, Shield HealthCare

  12. My 3 year old had a gtube for 18 monthes. She is typically developing with extreme failure to thrive secondary to severe oral aversion starting at 3 months old. After intense feeding therapy, she had her gtube removed 8 months ago, but she has regressed on her feeding despite our best efforts. Is it hard to have another tube placed? Do they put it in the same spot where her scar is?

    1. Hi Heather. We are sorry to hear about what your daughter is experiencing. There are many factors that will affect an updated treatment plan. Thus, the best advice would come from her doctor. It is important that you contact her medical team as soon as possible to have her evaluated. They will be able to determine if another tube is required and what the appropriate positioning will be.

  13. My husband had a feeding tube put in this past Friday to help him get nutrition during treatment of squamous cell head/neck cancer (HPV+). He was losing too much weight due to swallowing and eating issues from chemo/radiation.

    The surgery seemed to go well, but they pretty much “dumped” him out the door a couple of hours afterwards with absolutely zero explanation as to what to expect. Each day for intermittent periods, the site seems to “pulse” (you can actually see it), and it hurts so much when it’s doing that he can’t sleep – it will wake him up.

    While we’re seeing his oncologist later today, do you have any thoughts as to what might be causing that type of “pulsing” movement and pain at the site? This is the type of tube where you have to hold the tube and syringe up in order to “gravity feed” the nourishment. Then, he has to tape the tube to his skin to keep it from “flopping around”

    Any thoughts would be appreciated. Thanks very much!

    1. Hi Kathy. Thank you for reaching out. Sometimes patients have more pain then others after surgery and for many different reasons. Definitely ask the oncologist about the pain your husband is having today and ask them to look at the site. We also suggest calling the surgeons office today to follow up and get some advice on how to handle the pain he is having. Explain the location, frequency, and pain level when you talk to the medical team. We sincerely hope your husband finds relief soon.

  14. Thanks, Sarah. He saw his oncologist today – said it sounded a lot like “gas.” We’ll monitor over the next few days. Thanks again for your response!

  15. I had a peg fitting in lower intestine in 2019 from having it fitted I was in pain and infection. After going home I had problems with leaking and terrible pain. They eventually listened and took it out. No advice given. November 2020 started to leaking again last night I was in terrible pain so took morphine. Started to bleed during the night and has not stopped.

    1. Sharon-

      We are so sorry to hear about the pain and bleeding you have been experiencing and hope that you are feeling better. It is important to contact your medical team as soon as possible when this happens to rule out any complications.

      Thank you.

  16. Hello my son what’s recently changed from a 14 francs 3.5 button to a 14 French 4.0 button cuz he was very extended from the tummy now it’s time you calm down the button seems to fit loose what is cause discomfort while eating

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