Medical Nutrition Therapy: Gastrostomy Tube for Decompression HF#6434

  What is a Gastrostomy?

 

A gastrostomy (G-tube) is a procedure that creates a small opening in your outer abdomen into the stomach.  A thin tube is placed through this hole.  This tube is called a G-tube and will allow fluids to drain out of your stomach.

 

Why do I need a venting G-tube?

 

Inoperable tumors or treatments used to fight cancer can cause the stomach and bowels to stop working as they should. This can lead to nausea, vomiting or bloating. Placement of a G tube can reduce these symptoms and still allow you to enjoy eating some liquids. You will not absorb many nutrients because the liquids you drink will drain out the G-tube.

 

How often do I need to vent the tube?

 

Some patients may have gas, bloating, nausea, or vomiting after eating.  You will be able to “vent” the G-tube to allow air to escape when you have symptoms or need to allow the contents of your stomach to drain after eating.

 

How do I clean the G-tube site?

 

The G-tube needs to be cleaned daily to prevent infection.  For the first 3 days after the tube is placed, clean the skin around the tube with saline (see below) and then let air dry.  After 3 days, you may simply shower and let the water run over the area where the tube enters your skin.  If you can’t shower, clean with saline or water and swabs.

1. Gather all supplies needed: 4x4 split gauze, tape, cotton swabs, and normal saline
2. Wash hands well with soap and water for 30 seconds.
3. Open the sterile 4x4 split gauze and sterile Q-tips®.
4. Remove the old dressing.  Place the old dressing in a plastic bag and throw away.
5. Check the tube site for signs of infection.  These may include:

• Increased tenderness or pain
• Increased redness or swelling
• Drainage that is green in color or smelly
• Sutures (stitches) at the skin site that come loose.

6. Clean around tube under skin disc with Q-tips and normal saline.
7. Place the sterile split 4x4 gauze dressing on the skin.
8. Secure the tube with tape on your stomach.  This helps prevent the tube from being pulled out.

Giving Medicines

 

Medicine can be given with a syringe through the G-tube.  Be sure to crush pills in water until dissolved so that they do not clog the tube.  You may want to ask your doctor about getting the pills in liquid form.  Never crush enteric-coated or time-release capsules.  Flush the tube with 30 mL of water before and after giving medicines to be sure that it enters the stomach and to prevent clogging the tube.  

 

What can I eat?

You can eat anything that will be able to drain out the tube.  You will need to blend your favorite solid foods into a thin liquid or they will be too thick to come out the tube.  This will help you enjoy the flavors of the foods without the risk of clogging the tube. 

 

Ideas to help you enjoy the flavors of foods:

Strained canned soups

Cooked hot cereal (mixed very thin)

Carnation Instant Breakfast®, Ensure®, Boost®

Pureed fruits and vegetables

Yogurt or ice cream smoothies (mixed very thin)

You can blend your favorite foods by adding a small amount of fluid such as milk, cream, cream soups, sour cream, cottage cheese, smooth yogurt, ice cream (without nuts or chunks of fruit or candy), half & half, broth, fruit juice, tomato or vegetable juice to foods and then blending to desired consistency.

Ham with pineapple

Pork with applesauce

Beef with sweet potatoes

Vegetable purees thinned with soup

Use gravy or strained sauces or soup for added flavor

 

 

Common Problems

 

1.         Blocked tube

Gently flush the tube using 15 mL of warm water.  You may need to flush and pull out the water many times until the tube will flush.  If you cannot unclog your tube, call your hospice or home health nurse. 

 

2.         Excessive leakage around the tube

Call your hospice or home health nurse.

 

3.         Redness around the tube

Keep the skin around the tube clean and dry.  Some redness is normal, but moisture can irritate the skin and lead to an infection.

Clean the skin around the site more often using plain water.

Keep irritated areas open to air if possible.

Ask a nurse about other ways to fasten the tube in place.

Call the nurse if you see signs of infection (redness, swelling, rash, greenish drainage).

 

4.         Bleeding around the tube

If you notice more than a few drops of blood, call your nurse.

Keep the tube taped or secured tightly to your skin to prevent accidental pulls that might cause injury.

5.         Stitches come loose or tube falls out

If the tube falls out partly or all the way, do not try to push it back into the opening.  If you can, secure the tube with tape.

Call your hospice or home health nurse right away.  You may need to have the tube changed or replaced.

 

6.         Tube is punctured or torn

Clamp the catheter (or seal with tape), close to your skin.  Call your hospice or home health nurse right away.

 

7.         Noticing blood

If you cough up blood or see 25 cent size blood clots coming from the G- tube, call your hospice or home health nurse.

 

8.         Vomiting

Because the venting G-tube is put in for control of nausea and vomiting, if the tube is not clogged, you may need to adjust your nausea medicines.  Call your hospice or home health nurse if the tube is not clogged and nausea doesn’t stop.

 

9.         Dehydration

Vomiting, diarrhea, fever, and sweating cause the body to lose fluids.  You may no longer get thirsty so you must be very careful to note the signs of dehydration.  If you have any of these signs, call your doctor to find out how much and what kind of extra fluid to give at these times.

 

Decreased urine or darker colored urine

Crying with no tears

Dry skin that has no recoil when squeezed

Fatigue or irritability

Weight loss

Dizziness

Dry mouth and lips

Sunken eyes

Headache

 

Common Questions and Answers

 

Can I sleep on my stomach?

Yes.  After the tube site has healed, most people are quite comfortable on their stomachs.

 

Where do I get supplies?

You will receive supplies from the inpatient unit when you are discharged. Your hospice or home health agency will provide you with more supplies as needed.

 

 

Teach Back:

 

What is the most important thing you learned from this handout?

 

 

What changes will you make in your diet/lifestyle, based on what you learned today?

 

 

 

 

 

If you have additional questions, please call your hospice or home health agency.

 

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 02/27/2013

Copyright © 02/27/2013 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6434

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