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HealthInfo Waitaha Canterbury

Tube feeding with a gastrostomy tube

Whāngai ā-ngongo ki te ngongo ā-puku

This factsheet tells you how to care for your feeding tube and stoma (the artificial opening into your stomach). It also tells you how to take your feed and medications via your tube.

Gastrostomy

A gastrostomy is an artificial opening through your abdomen into your stomach. A feeding tube is inserted through the opening so that special liquid food (feed), medications and fluids can go directly into your stomach. Some feeding tubes go down into your jejunum, a part of your small intestine.

There are 2 types of gastrostomy tube. PEG (percutaneous endoscopic gastrostomy) is one. RIG (radiologically Inserted gastrostomy) is the other. These terms describe how the tube is fitted.

PEG and RIG tubes both have centimetre (cm) markings.

Feeding tube photos showing a tube coming out of a person's stomach with a flange holding the tube in place, a clamp stopping anything flowing into or out of the tube and a feeding port

A – Feeding port. B – Flange (bumper). C – Clamp. D – Balloon inflation-deflation port.

PEG tube

The PEG tube has a flange (bumper) inside your stomach to keep your tube in the right position. The tube can remain in place for 18 months or longer.

The MIC-KEY button is a low-profile PEG device. It is used with an extension set that is needed to access the feeding port.

RIG tube

The RIG tube has a water filled balloon that holds the tube in your stomach. The nurse will show you how to check the balloon.

The tube needs to be replaced approximately every 6 months. This is a very simple procedure, and the PEG nursing service will contact you to arrange a clinic appointment.

If the flange (bumper) is at the same cm marking but further away from your skin than normal, the balloon may have deflated. If this happens, try to push the tube back into its original position and tape it down. Contact the PEG Nursing Service urgently (see the contact details below).

Feeding

Flush your feeding tube with warm water before and after you tube feed. Also flush it before and after you take medications down your tube.

If you have safe drinking water, you can use tap water to flush your tube. Otherwise, use boiled, cooled water.

If you have a jejunal tube, always use boiled, cooled water to flush your tube.

Important

Only put the following down your feeding tube:

Do not put puréed food down your feeding tube.

Feeding methods

There are 3 methods of tube feeding, gravity feeding, bolus feeding and pump feeding. Your dietitian will decide which type of feeding is best for you.

Gravity feeding – This is where the feed flows out of a syringe or feed bottle and into the feeding tube by gravity.

Bolus feeding via a syringe – This is when you have a set amount of feed at specified times during the day. This is like having meals at mealtimes.

Pump feeding – This is when a pump is used to continuously deliver a set amount of feed through your feeding tube over a set amount of time.

Your dietitian will discuss the options with you in more detail and provide you with a plan and instructions when needed. See:

Medications

The hospital pharmacist will review your medications before you go home. They will make sure you can take your medications through your feeding tube. There are some important points to note.

Caring for your equipment and feed

Caring for your feeding tube and stoma

Your stoma

Your feeding tube

Important

If your feeding tube comes out, your stoma will begin to close within 2 to 3 hours.

Contact the PEG Nursing Service immediately. You may need to go to the hospital to have it put back in.

Troubleshooting

Problem

Possible cause

Recommended action

Your skin around the tube is very red and painful and there is pus.

You may have an infection. First check that the flange is not too firm on your skin.

See your general practice team who may prescribe antibiotics.

Your skin is “raw” around the tube insertion site.

You may have what is called overgranulation tissue.

This is common and easily treated. Contact the PEG nursing service within normal working hours.

The feeding tube is blocked.

Try to unblock it using a 60 mL syringe half filled with warm water. Use a gentle push pull method to dislodge the blockage.

If you cannot clear the blockage, contact the PEG nursing service. If after hours, contact the on-call service.

Feed is leaking during feeding.

Your tube may have come out of your stomach but still be sitting under your skin.

Contact the PEG nursing service. If after hours, contact the on-call service.

Supplies, syringes and giving sets

Contact the Te Whatu Ora Waitaha Supply Department (see below).

Give as much notice as possible. Let them know if you cannot collect the giving sets as they can courier them to you. There is no charge for giving sets, syringes or delivery.

If you are under the care of the Ashburton Hospital dietitians, phone the Ashburton Supply Department (see below). You will need to collect your giving sets from the Supply Department.

Your hospital dietitian will organise your feed when you first go home. After this, your community dietitian will organise it. If you need to contact your feed supplier because your feed has not arrived, use the contact details below.

Contact details

PEG Nursing Service

Phone: 027-351-2474, or (03) 364-0640 ext. 88945

Hours: Monday to Friday, 7.30 am to 4.30 pm

For urgent help after hours (only after hours). For example, if your tube falls out, phone Christchurch Hospital on (03) 364-0640 and ask to speak with the Gastro Nurse on call.

Te Whatu Ora Waitaha Supply Department

Phone: (03) 364-0082 or (03) 364-0080

Address: 4 Rapide Way, Yaldhurst (near the airport)

Hours: Monday to Friday, 7.30 am to 4.30 pm.

Ashburton Hospital Supply Department

Phone: (03) 307-8462

Address: Ashburton Hospital, Entrance D, 12 Elizabeth St, Ashburton

Open for collection: Monday to Friday, 10.30 am to 2.30 pm.

Feeding pump suppliers

For any issues with your pump, use the following contact details:

Feed suppliers

Written by Nutrition & Dietetics and PEG Nursing Service, Te Whatu Ora Waitaha. Adapted by HealthInfo clinical advisers. Last reviewed September 2021.

Sources

Page reference: 482996

Review key: HITUB-482880