FAQs

• A gastrostomy is a way to feed directly into the stomach and a jejunostomy feeds directly into the small bowel (intestine).
• You can not bolus feed through a jejunostomy tube as the diameter of the small bowel will not tolerate the volume as does the stomach.

• Flush, flush, flush.
• Flush with water after each feed and after each medication.
• Do not mix medications in the same syringe.
• Try to use a liquid form of medication if available.
• Avoid using the antibiotic clarythromycin.

• Try to flush with warm water using a push/pull method to try to unplug the tube.
• If this is unsuccessful, try using a cotazyme capsule mixed with sodium bicarbonate and water to unplug the tube.  
• Mix the powder of a cotazyme capsule with 1/2tsp of baking soda or 325mg of sodium bicarbonate with a some warm water.
• Put this mixture into the feeding tube.
• Use the push/pull method to try to unblock the tube.
• You can repeat this two (2) times.
• You can leave the solution inside the tube for up to one (1) hour.
• If this is unsuccessful, you will need to arrange to have the feeding tube changed.

• Hypergranulation tissue is believed to occur as a result of an extended inflammatory response
• We believe it may be caused by a reaction to the tube - the body is in fact "walling off" the tube
• Pressure, moisture and friction may also contribute to the development of hypergranulation tissue 
• Hypergranulation tissue leaks a yellow, sticky drainage and it is often described as itchy, this tissue may bleed easily

Hypergranulation tissue (proud flesh) can affect the seal of the feeding tube. It may increase the amount of stomach contents that leak from the stoma. The drainage from the tissue can be irritating to the surrounding skin.

Silver Nitrate application

Silver Nitrate sticks can be used to cauterize (burn) the hypergranulation tissue. We suggest a five-day course of once daily treatments. Ensure that the surrounding skin is well protected prior to treating the hypergranulation tissue.

Cortisone cream application

A short course of a low dose cortisone cream can also be applied to the hypergranulation tissue as ordered by a healthcare provider.

• Do not panic – this is not an emergency.
• When a feeding tube is pulled out, the stoma will start to close. Some stomas can close in a few hours.
• Always carry your emergency replacement kit which should include:
• replacement feeding tube (Foley / replacement tube)
• 5 ml syringe
• water
• clamp or cap (for Foley)
• washcloth
• water-based lubricant
• waterproof marker
• emergency phone numbers
• change for a phone call
• notes on replacing the GT
• If the gastrostomy is new (the operation / procedure was in the last six weeks) a doctor should reinsert the tube (to make sure that the feeding tube goes back into the right spot) unless otherwise directed by your doctor.
• Otherwise you need to:
• Wash your hands.
• Draw up 5ml water into your 5ml syringe.
• Have child lying flat – relaxed if possible.
• Fill the balloon with water – to check the balloon for leaks.
• Remove the water from the balloon.
• Put lubricant on the end of the tube.
• Put the moist tube into the stoma – hold the end of the tube upright – so it won’t leak on you.
• Use the syringe to put 5ml of water into the balloon port, then remove the syringe.
• If you feel resistance, don’t use force – try again.
• Pull gently on the tube to ensure that the balloon is snug against the stomach wall.
• Close the tube and clean the skin around the tube well.
• Mark the tube (if using a Foley) at skin level with a waterproof marker.
• Secure the tube in place - with tape.
• If you are not sure that the feeding tube is in the right place – DO NOTuse the tube for feeding. Contact your doctor.

• Most children who are on home feeding regimes are under the care of a pediatrician. Your pediatrician of family doctor will follow your child’s feeding and weight gain concerns.
• Map out a plan of who is available in your community – you can discuss this with your healthcare provider.
• Call your child’s surgeon if there is a fever, redness, swelling or green drainage from the stoma site around the time of surgical insertion (first 3 months).