A gastrostomy is a device inserted through an opening that is made surgically from the abdomen on the outer skin into the stomach. You can find medical information about the gastrostomy on the GOSH website. Having a gastrostomy tube, means that your child can be fed directly into the stomach. The kind of feeds that ideally go through the gastrostomy are in liquid form. So things like milk, water and medication are given through the gastrostomy. It is not correct to give anything into the gastrostomy if the doctor have asked you not to do so.
Sometimes in children with stomach/abdominal problems, the gastrostomy is not for feeding into the stomach but for allowing excess secretions to be expelled from the stomach. There are many gastro-intestinal conditions that can lead to this but it is quite normal for the gastrostomy to be used for this. If this is suggested to you as a parent , please do not be alarmed. For us as a family, it was very traumatic to hear that our son had to have this bag. Considering all he had been through, we felt “what else could possibly go wrong”. The good news is that with time, we became more welcoming of this extra bag as we saw the relief it gave our boy. So if this is you right now, just hang in there!
For the excessive gastric fluids (or juices from the stomach) to be expelled, a bag is attached to the end of the gastrostomy tube. The doctors used the term “free drainage” to refer to this new bag that our son had to have. You may also hear medical staff say “the gastrostomy is on free drainage” don’t worry, it means the same thing.
So what do you have to do on a daily basis with a gastro bag? Here are 3 of the things I did and found most helpful:
- Empty contents regularly : The bag is emptied at intervals daily. Sometimes the bag can be full of air or bubbly juices. Removing the bubbles from the bag can also help to relieve the child. The bag should be emptied regularly because, if it gets too full, it will be heavy thereby pulling on the stoma (this is what the doctors call the hole through which the gastrostomy tube comes out of the stomach). It can also make the child vomit causing more discomfort.
- Check the colour of the juices – Ensure the colour of the juice in the gastro bag is not bloody, greeny or any colour other than advised by your medical team. If this is the case, make sure that you contact your medical team as soon as possible because it may be an indication of something. It may also be nothing but it is best to get their advice.
- Check the gastrostomy stoma site: Sometimes the gastrostomy stoma site can become smelly, oozy or have abscesses. You also need to check the site daily for this. If this is the case, you also need to let the medical staff know so that they can advise you. Sometimes, you may need to be seen for the doctor to decide what to do. It may not be anything major but as you know it is hard for doctors to make decisions over the phone hence, the need to see the your child for a proper assessment to be made. They may also take swab samples of the oozy gunk to look at under a microscope. This will tell the doctors if there is an infection or not. Some infections require antibiotics or other medicines to be ingested. Some other infections can be topical (on the skin). They may give you a cream to apply daily. Generally, these are quite normal occurrences with the gastrostomy that can be resolved if reported quickly.
To help avoid ooziness around the gastrostomy stoma site, It is a good idea to clean it daily. Here is how I did:
1 – Use a disposable towel or a dedicated towel.
2 – Moisten with water
3 – Loose the triangle around the gastrostomy (PEG) this will not be required for a MIC button type of gastrostomy
4 – Clean around the site, wipe thoroughly
5 – Examine site for any irregularities or anything unusual
6 – Put triangle back.
If there is oozing – report it immediately. Only after that and on doctors advise can you care daily. You can
1 – Follow steps 1-5 above *
2 – Apply cream if given.
3 – Put some gauze around the gastrostomy to soak ooze.
4 – Put some paper tape ( only if your are sure that your child is not allergic ) to hold it in place
For gastrostomy bags, there are nice pouches you can buy on amazon to help the child carry the bag discretely. These bags strap around the child’s waist comfortably and the gastro bags can be placed inside.
If the gastrostomy extension is too mobile you may ask your HCP for clinifix to help stick the tube against the skin.
For PEG users :
To stop the gastrostomy disc from sticking/embedding into the stomach wall, ask your nurse to show you how to push, pull and rotate the device. This is advised once a week. You can:
1 – Open the triangle to release the gastro tube.
2 – Push it into the stomach up to one centimetre
3 – Rotate the tube 360 degrees.
4 – Pull back towards yourself ( the 1 centimetre that you pushed in early )
5 – Secure back in the triangle
Thank you for reading.
If you enjoyed reading this, you may also enjoy some other topics we have discussed in this series.
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