Gastrostomy tube insertion

Alternative names
Feeding tube insertion - gastrostomy; G-tube insertion; PEG tube insertion; Stomach tube insertion

Definition
This is an insertion of a feeding tube into the stomach.

Description

This is often done through endoscopy (a long tube placed through the mouth into the stomach) by a gastroenterologist. Local anesthesia and intravenous sedation are used.

It may also be done surgically. While the patient is deep asleep and pain-free (general anesthesia), a small incision is made on the left side of the abdomen. A small, flexible, hollow tube (catheter) with a balloon or flared tip is inserted into the stomach. The stomach is stitched closed around the tube and the incision is closed.

Indications
Gastrostomy tubes are inserted for various reasons. They may be needed temporarily or permanently. Gastrostomy tube insertion may be recommended for:

• Birth defects of the mouth, esophagus, or stomach (esophageal atresia or tracheal esophageal fistula)
  
• Patients who cannot swallow correctly
  
• Malnourished patients who cannot take enough food by mouth to maintain their nutrition
  
• Patients who continually aspirate when eating

• Reactions to medications
  
• Problems breathing

• Bleeding
  
• Infection

Convalescence
The stomach and abdomen will heal in 5 to 7 days. Moderate pain can be managed with medications. The patient will be fed intravenously (IV) instead of by mouth for at least 24 hours. Feedings will begin when bowel sounds are heard. Feedings will start slowly with clear liquids and gradually be increased.

The patient/family will be taught:

• How to care for the skin around the tube
  
• Signs and symptoms of infection
  
• What to do if the tube is pulled out
  
• Signs and symptoms of tube blockage
  
• How to empty (decompress) the stomach through the tube
  
• How and what to feed through the gastrostomy tube
  
• How to conceal the tube under clothing
  
• What normal activities can be continued

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