A feeding tube (G-tube, NG-tube, or J-tube) provides nutrition or medication directly into the gastrointestinal tract. Proper cleaning of the tube and the surrounding skin site is the primary method for preventing complications like infection and blockages. Consistent hygiene ensures the tube functions correctly and preserves the integrity of the device and the health of the skin around the insertion site.
Essential Supplies and Preparation
Before cleaning, gather all required supplies and ensure proper hand hygiene. A clean environment and the correct tools simplify the process and minimize the risk of introducing bacteria. Handwashing with soap and water for at least 20 seconds, or using an alcohol-based sanitizer, should always be the first step.
The cleaning process requires a large-volume syringe (30 mL to 60 mL) for flushing the internal tube lumen. Clean water (tap, sterile, or cooled boiled) is needed for flushing, as directed by a healthcare professional. Mild, fragrance-free liquid soap is recommended for cleaning the skin and external tube parts. Clean gauze pads, cotton swabs, or a soft washcloth are also needed to gently clean and thoroughly dry the area.
Internal Flushing Procedures
Flushing the feeding tube’s interior prevents formula and medication residue from building up and causing an obstruction. The tube should be flushed immediately before and after every administration of feed or medication. Even when the tube is not actively being used, it requires flushing at least once daily to maintain patency.
To perform a flush, the required amount of water (usually 15 mL to 30 mL for adults) is drawn into the syringe. Connect the syringe securely to the tube’s port, ensuring the connection is firm to prevent leakage. Administer the water slowly and steadily with a gentle push on the plunger.
If the plunger meets resistance, use the “push/pause” method. This involves pushing the water a small amount, pulling back slightly, and repeating the action gently. This movement helps loosen residue sticking to the tube’s inner walls. After the water has been instilled, disconnect the syringe, and immediately cap or clamp the port to prevent leakage and air entry.
Stoma and External Tube Maintenance
Care for the stoma (the opening where the tube enters) and the external tube components prevents skin irritation and infection. The skin around the tube should be cleaned daily, or more frequently if discharge or leakage is present. The cleaning process involves using a clean gauze pad or cotton swab moistened with warm water and mild soap.
Clean the area gently in a circular motion, starting close to the insertion site and moving outward to remove crusting or dried drainage. Gently lift the external retention device (such as the bumper or disc) to clean the skin directly underneath. Thoroughly pat the skin dry with a clean cloth or gauze, as moisture promotes fungal growth and skin breakdown. The external length of the tube, including the feeding port, can also be wiped clean with soapy water and dried.
Addressing Blockages and When to Contact a Healthcare Provider
A blockage is signaled by difficulty pushing formula or water through the tube with normal pressure. If this occurs, attempt to clear the obstruction using a 30 mL or 60 mL syringe and warm water. Attach the syringe to the tube and apply gentle pressure to push the warm water into the blockage.
If the water does not flow immediately, use a gentle push/pull motion on the syringe plunger to create negative and positive pressure to dislodge the material. If the obstruction persists, clamp the tube and allow the warm water to soak for 15 to 30 minutes to soften the residue. Then, the push/pull technique can be tried again. Avoid using unapproved substances like acidic juices or meat tenderizers, as these can worsen the blockage or damage the tube material.
Contact a healthcare professional immediately if the blockage cannot be cleared with warm water and gentle pressure. Prompt medical attention is also required for signs of infection.
Signs of Infection or Emergency
Signs of infection include:
- A fever
- Significant redness and swelling around the stoma
- Persistent pain
- Thick, foul-smelling, or purulent drainage
If the tube becomes dislodged or falls out, especially if placed recently, cover the site with a clean dressing and seek immediate clinical assistance. This is considered a medical emergency.