Tube feeding using a gastrostomy tube

A gastrostomy tube is used if you need longer-term support with feeding or receiving nutrients. Once placed, it can last for 2 years but can be removed sooner.

There are many reasons you may need a gastrostomy tube. Some people have disorders affecting their swallowing, and there is a risk of breathing in food or drinks (aspiration). Other people have problems affecting their digestive system that mean food or drinks cannot travel down the food pipe (oesophagus) into the stomach. 

Sometimes a gastrostomy tube can provide extra nutrition to stay healthy during certain medical treatment, such as for cancer and blood disorders.

The main types are percutaneous endoscopic gastrostomy (PEG) and radiologically inserted gastrostomy (RIG). Others include a surgically placed gastrostomy tube or a low-profile gastrostomy.  If your gut does not work, a percutaneous endoscopic gastrojejunal gastrostomy (PEGJ) or a surgically placed jejunostomy (JJ) is used.

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Percutaneous endoscopic gastrostomy (PEG)

A soft, flexible tube that has a camera and a light (endoscope) is passed down your food pipe into your stomach. A small opening (stoma) is made through the skin of your abdomen into your stomach. The tube is secured in your stomach with a bumper.

Radiologically inserted gastrostomy (RIG)

A thin flexible tube (nasogastric tube) is passed down your nose directly into your stomach. Air is pushed into your gut through the tube in your nose. After your belly is numb, an area is formed to fit the feeding tube. A radiologist will use x-ray guidance to place the tube. It is held in place with stitches and 2 or 3 buttons on the skin near your stomach. These buttons will fall off after a few weeks as the stitches dissolve. A balloon filled with water inside your stomach keeps the tube in place.

Percutaneous endoscopic gastrojejunal gastrostomy (PEGJ)

A PEG is placed as described above. A jejunal tube is then inserted through the PEG tube and into the jejunum (a part of your small intestine).

Surgically placed gastrostomy (G-tube) or jejunstomy (JJ)

This is placed by a surgeon in your gut or intestine while you are put to sleep with anaesthetic. 

The main types of feeding are bolus, pump feeding or a combination of both. A dietitian will help you decide what is best for you to meet your nutritional needs. Only prescribed medicines, feed and water should be given down a tube. You will need to sit up or have your upper body at a 30-degree angle during feeding and for at least 30 minutes after.

Bolus feeding using a syringe

A set amount of feed is given at certain times during the day, like having regular meals and snacks. Gravity can be used to provide the feed – poured into the syringe like a funnel, or pushed through a syringe with the plunger.

Pump feeding

• The feed is slowly given over several hours to deliver a set amount using a special feed pump.
• A special tube (giving set) is connected to the feed through the pump and then to the feeding tube. You will need a new giving set each day.
• Your nurse, dietitian or nutrition company representative will teach you how to use the feeding pump. Written instructions are also given.

A gastrostomy is a safe procedure, but there can be problems. Leakage of feed or fluid around the tube onto your stomach skin, pain and mild bleeding is normal for the first 1–2 weeks after the tube is placed.

Another minor problem is an infection at the stoma site.

Poor wound healing and infection (granulation) can happen around the stoma site. To lower the risk of this, keep your tube clean, dry and taped up rather than tucked into your trousers or skirt.

Let your doctor or nurse specialist know if you have these problems.

If your feeding tube becomes blocked, contact your doctor or nurse specialist immediately. If it falls out, quickly put the tube back in the stoma site. Do not use the tube. Contact your doctor or nurse specialist quickly, or go to the emergency department.