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Gastrostomy
What is a gastrostomy?
A gastrostomy is the creation of a new opening into the stomach. A small incision (stoma or opening) is made in the skin and stomach wall. A feeding or gastrostomy tube (G-tube) is inserted into the stomach. This tube delivers the medicine or food necessary for your child to grow or feel better.
Who gets a gastrostomy tube?
Children need gastrostomy tubes if they are born with any medical condition that prevents a child from eating enough and swallowing safely. A child who is premature, who has an abnormal esophagus, chronic lung disease, failure to thrive, short bowel syndrome, or heart disease with poor feeding and growth may need another way to get food and medicine. Children with pseudo-obstruction or other problems moving food from the stomach into the intestines might require a gastrostomy for emptying food or air from the stomach.
How is the decision made that surgery is needed?
Your physician will discuss reasons for the operation with you and will help you decide if your child will benefit from a gastrostomy tube.
What can I expect from surgery?
Children usually gain weight and feel better when they receive needed food and medicine. These improvements may also help them fight off germs and prevent infections.
Tips for the day of surgery—what to bring, what to leave home.
Bring your child’s favorite doll or toy to the hospital. Caretakers should wear comfortable clothes and are welcome to stay with their child during the hospital stay.
When will my child be able to go home?
Your child will go home when s/he is comfortable and able to take food and fluids. Before discharge, your nurse will teach you how to care for your child’s gastrostomy tube, give feedings, medications, and troubleshoot common problems.
How much time should I plan off work?
Many parents take off approximately two weeks for their child’s surgery and recovery at home. We can write a letter to your employer explaining the need for you to be with your child during this time.
What care is needed at home after surgery?
- Care of the incision: Wash your hands with antimicrobial soap before touching the gastrostomy area. You may use warm soap and water to gently clean around the gastrostomy site twice a day or as needed. Make sure that you remove all the crusted areas on the skin around the tube. You may use diluted hydrogen peroxide (1/2 peroxide, ½ water) and Q-tips to clean the site for the first two weeks. After cleaning, rinse with water and pat dry.
- Activity limitations: Your child may participate in all normal activities including lying on his/her stomach as long as the tube is secure so that it will not accidentally be pulled out. Make certain the G-tube is carefully secured under his/her clothing.
- Diet: Children will be provided with a nutritional plan before leaving the hospital. Fluids that can be given through the gastrostomy tube are milk, formula and water. Liquid medications or well-crushed pills diluted with liquid may also be given. Always flush the G-tube with water before and after each feeding or medication.
- Bathing: For one week following the surgery, your child should avoid swimming or soaking in a bathtub.
- Medication: Your physician or nurse practitioner will provide a prescription for pain medication prior to discharge from the hospital. If your child’s pain is not controlled on this medication, please call the surgeon.
When should I call the surgery team?
Call with temperature greater than 101F., redness around the G-tube site, an increase in gastrostomy drainage, accidental tube dislodgement, nausea, vomiting, diarrhea, pain uncontrolled by medications prescribed, or any questions or concerns. The postoperative appointment should be scheduled prior to your child’s discharge from the hospital.
What should I tell my child’s teacher?
When your physician allows your child to return to school, tell your child's teacher and school nurse about your child's gastrostomy. You will want to tell them what to do and whom to call in an emergency. A spare gastrostomy tube or “to go kit” should always accompany your child to school.
What are the long-term consequences?
A gastrostomy will provide the extra nutrition and medicine necessary for your child to reach his or her very best potential in life.
Will this affect growth and development?
Children who are G-tube fed have the same development as other children. They will grow better with the optimum amount of calories the G-tube can deliver.
Is there anything else I need to know to care for my child?
Simply, keeping the gastrostomy site clean and dry, and tension off the site will prevent the majority of complications with a gastrostomy tube. ALWAYS keep a spare tube available, and replace immediately if the tube accidentally is pulled out. You are not alone, and only a phone call away if there are new questions or concerns after discharge from the hospital.
Please reproduce and distribute this sheet to your surgery families. This teaching sheet can also be downloaded at www.APSNA.org.
Copyright 2006, Lynne Farber. Copied with permission by Jones and Bartlett Publishers, Sudbury, MA.