A gastrostomy tube, called a G-tube for ease, is a way for your child to get the necessary nutrients. Even though this surgical procedure may be scary for some people, children can still live healthy, active lives following the procedure.
What Is a G-Tube?
A child may need a G-tube if they don't get proper nutrients, calories, and fluids through eating. The gastrostomy tube is surgically inserted into the stomach, and the child gets food, medications, and fluids through it.
There are many types of G-tubes, but the two most common are low-profile (button) tubes and long tubes.
Low-profile tubes. These gastrostomy tubes are sometimes called button tubes. They rest at skin level with a balloon device beneath the skin that holds them in place. There's a "button" where extensions are attached for feeding.
Long tubes. There are many types of long tubes. As the name implies, these long tubes protrude from the skin and allow for feeding without extensions or attachments. Long tubes typically need gauze, tape, and other bindings to prevent your child from pulling on the tube.
Who Needs a G-Tube?
There are several reasons your child may need a gastrostomy tube.
Congenital health problems. Health conditions involving your child's mouth, throat, stomach, and intestines may prevent them from eating properly. Since a child is born with these conditions, a G-tube will likely be inserted early in their life to make sure they develop well.
Sucking and swallowing problems. Your child may have difficulties sucking and swallowing, which will make it challenging to get the necessary nutrition. These conditions may result from:
- Premature childbirth
- Delayed development
Failure to thrive. The term " failure to thrive" describes a child who isn't gaining weight and growing as much as they should. Failure to thrive may result from many health problems, but a G-tube can help provide a child with the necessary calories.
Trouble taking medicine. No child likes taking their medicine. In extreme scenarios, a child may get a G-tube to make sure they're getting necessary medications.
G-Tube Placement: Preparation
Initial testing. Your doctor will call for some tests before performing a gastrostomy. For example, they commonly X-ray the child's gastrointestinal (GI) system to prepare for a G-tube placement.
Establish a care plan. Living with a G-tube involves lifestyle changes. Your doctor will likely recommend meetings with a dietitian, gastroenterologist, or social worker to establish a care plan at home.
Preparing for the procedure. Your child will undergo typical preparations for a surgical operation. A care team will set them up to monitor their vitals. They'll also insert an intravenous (IV) line to administer medicine and anesthesia.
G-Tube Placement: Procedure
The procedure is called a gastrostomy. There are two primary ways to insert a G-tube:
Percutaneous endoscopic gastrostomy (PEG). The most common gastrostomy is a PEG. It's not as invasive as open surgery and is generally easier on your child.
Your child will get a local anesthetic, pain reliever, and sedative to relieve pain and significant discomfort during the procedure. The procedure is short, and your child can stay awake throughout it. A PEG procedure typically only takes 30 to 45 minutes.
The doctor makes a small incision on the abdomen. After making another incision in the stomach, they insert the G-tube by running it down your child's throat. They finally secure the tube and send your child on their way.
Open surgery. An open surgical procedure is less standard than a PEG. The doctor will put your child under general anesthesia, so they won't be awake for the surgery.
The surgeon will make an incision in the stomach and stitch the G-tube into place. Children who would have difficulties with an endoscopy may require open surgery. Alternatively, a child who needs other stomach surgeries may receive an open surgery simultaneously.
Laparoscopic method. Your doctor may be able to do a laparoscopic procedure as an alternative to a PEG procedure. Instead of an endoscopy, the surgeon inserts a laparoscope in one incision to help the G-tube placement. The rest of the procedure is similar to a PEG.
G-Tube Care and Maintenance
G-tubes need regular and thorough maintenance. A care team will work with you to develop an appropriate care routine. Improper care of your child's G-tube can lead to complications like infections and leakage.
Your doctor and care team will also teach you what to feed your child through the G-tube, handle possible complications, and much more.
Regular cleaning. Wash your hands before and after tending to the G-tube. Wash the skin around the tube with warm soapy water and dry it well. While cleaning, check the skin around the G-tube for abnormalities like swelling, leaking, redness, and excess skin growth.
Flushing the tube. You need to flush the G-tube after feeding or giving medications. You'll use a syringe of clean water to flush the G-tubes.
If you use extensions for low-profile tubes, you'll need to flush, clean, and dry them thoroughly. If you can't clean them entirely, you'll need to throw them away and use new extensions.
Activities. Your child can return to most of their typical activities. Regularly check for leaks after they finish playing and contact your care team if there are any problems.
Teach your child not to pull the G-tube. You can secure the tube with a wrap and tape for long G-tubes. You can use a young child's onesies or shirt snaps to keep the tube close to their body.
Let your school and caretakers know about your child's G-tube. You and your care team should also give them tools and information in case of emergency.
Since it's an invasive surgery, the G-tube procedure poses some risks, such as infection and bleeding. Your surgeon will do everything they can to remove potential risks during the surgery.
You can avoid many G-tube complications with appropriate care and maintenance. Improper care can lead to:
- A dislodged G-tube
- A clogged tube
- Leaking or drainage
- Belly pain
- Repeated vomiting or diarrhea
- Gas buildup
- Difficult bowel movements
When they are caught early, you and your doctor can treat these G-tube complications.