and how I would respond.

Transcription

1 Our Journey with Tube Feeding (G-Tube or J-Tube) Si usted desea esta información en español, por favor pídasela a su enfermero o doctor. I can tell you what problems may occur with tube feedings 1. Sore Skin Around the Stoma What it looks like: red, sore, swollen, unusual drainage. There may be more drainage around the tube. The skin around the tube is infected. Formula or medicines have spilled onto the skin around the tube. Stomach fluid is leaking around the tube. The stoma may not have dried completely after it got wet. The current routine cleaning of the stoma is not enough to keep the skin healthy. and how I would respond. Clean the stoma and skin four or five times a day using soap and water until the area looks better. Use a cotton swab to reach around the tube. Dry the stoma and skin well after cleaning, bathing and swimming. When formula is spilled on the skin, clean it right away. Use a cotton swab to reach around the tube. 1 of 5

2 The stoma needs to be open to air as much as possible to stay healthy. Do not cover the stoma with a lot of gauze, tape or cream. If you need to use gauze, take it off when it gets wet or dirty. If your doctor tells you to use cream on the skin around the tube, put on a very thin layer. When using tape, use as little as possible. Do not cover the stoma. If these do not help, call your doctor. Your doctor may tell you to use povidone iodine, antacids, or antibiotic creams to help the stoma heal. Call your doctor if the stoma has drainage that smells bad, if the tube is leaking. 2. Leaking Around the Stoma What it looks like: wet skin around the stoma. The tube is too small for the size of the stoma. The skin around the tube is infected. The tube does not fit snug against the wall of the stomach. Scar tissue prevents a tight fit. There is a hole in the tube. Tape the tube in place. Pull gently on the tube to help it fit more snugly, then tape the tube in place. For buttons: Check to make sure the balloon is filled correctly. If the tube still leaks, call your doctor. The tube may need to be changed. 2 of 5

3 3. Bleeding at the Stoma What it looks like: blood or dried blood around the stoma. The tube is moving too much and making the stoma sore. The stoma is infected. The tube is too small and is making the stoma sore. A lump of inflamed skin (granuloma or granulation tissue) is forming around the stoma. Treat the stoma like you would for Sore Skin Around the Stoma. If the bleeding continues or gets worse, call your doctor. 4. Clogged Tube What it looks like: medicine, formula, or water does not pass through the tube into the stomach as easily as it used to, or it cannot pass through at all. Dried food or medicine is stuck in the tube. Put 2 or 3 cc of water into a syringe. Flush water through the tube to unclog it. If that dosn t work, try flushing with 5 to 15 cc of warm water. If the tube is still clogged, call your doctor. Always flush the tube with water after you give medicine or feed your child through the tube. Medicine you give through the tube should be liquid or mixed with water so it becomes a liquid. See: How to Give Medicine Through a Tube 3 of 5

4 5. Throwing up, loose stools, or belly pain What it looks like: Your child throws up, has belly pain, or has very loose, watery stool. The feeding may have been too large. The feeding may have been given too fast. The formula may have been too cold. Your child may be sick. There is something about the feeding your child cannot handle. The tube may have moved and is not working the way it should. Feed formula at room temperature. Give the feeding slower. Your child may need smaller feedings. Call your doctor before changing your child s feeding schedule. Check the position of the tube. Gently pull the tube up so it fits against the abdomen. If the throwing up, pain, or loose stool continues, call your doctor. 6. If the Tube is Pulled Out If the tube is pulled out, the stoma may bleed and your child may cry. When a tube is put in, it takes four to six weeks for the stoma to heal. If the tube is pulled out during this time, call your doctor right away or go to the emergency room. Another tube will be put in. If the tube is pulled out, the stoma may bleed and your child may cry. 4 of 5

5 Once the stoma is healed, it will stay open for several hours if the tube gets pulled out. Call your doctor right away. In the next few hours you will have to see your doctor or go to the hospital to have a tube put in. If you don t replace the tube in a few hours, the stoma may begin to close. Ask your doctor if your child has a tube that can be replaced at home. If you tape the tube to the belly, and cover it with clothes, it will help keep the tube in. Clothes that snap closed between the legs cover the g-tube well. 7. Extra Skin It is normal for a small amount of skin to grow around the tube. This skin is called granulation tissue. This is usually not painful. Granulation tissue can be formed by the tube moving against the stoma. You may prevent it by holding down the extension tubing on the child with tape. If this skin tissue becomes large, looks sore, or it makes it hard to clean the stoma and button, call your doctor. This tissue often bleeds. Disclaimer The information provided at this site is intended to be general information, and is provided for educational purposes only. It is not intended to take the place of examination, treatment, or consultation with a physician. Phoenix Children s Hospital urges you to contact your physician with any questions you may have about a medical condition. 5 of 5