A gastrostomy tube, commonly known as a G tube, is a medical device used to provide artificial nutritional support when a person cannot safely or adequately eat by mouth. This flexible tube is a form of enteral feeding, delivering nourishment directly into the digestive system and bypassing the need for oral intake. The G tube provides a secure pathway for delivering formula, water, and necessary medications directly into the stomach.
Decoding the Name and Function
The name “G tube” is an abbreviation for Gastrostomy Tube, which refers to the creation of an opening into the stomach. The root “gastro” signifies the stomach, and “ostomy” indicates a surgically created opening. This tube creates a direct channel from the external abdominal wall into the stomach’s interior.
The primary mechanism involves a small, healed tract, called a stoma, created between the skin and the stomach lining. The tube itself is a soft, flexible silicone device secured internally by an inflated balloon or a fixation disc, and externally by a bumper or retention ring. This design allows the tube to remain securely in place for long-term use, facilitating the delivery of specialized liquid nutrition and fluids.
Clinical Reasons for Placement
Placement is recommended when a patient has a functional digestive tract but cannot take sufficient sustenance orally. The most common indication is dysphagia, or difficulty swallowing, often caused by neurological conditions like stroke, cerebral palsy, or amyotrophic lateral sclerosis (ALS). When swallowing is impaired, a G tube prevents aspiration, where food or liquid enters the lungs.
Other reasons include the inability to meet caloric needs, seen in cases of severe malnutrition, cancer treatments, or chronic illnesses causing loss of appetite. In pediatric care, G tubes are used for infants and children with congenital abnormalities that prevent normal feeding. The tube ensures they receive the necessary calories and nutrients for proper growth and development.
The Placement Procedure
The most frequent method for inserting a G tube is the Percutaneous Endoscopic Gastrostomy (PEG) procedure, which is less invasive than traditional open surgery. A gastroenterologist uses an endoscope, passed through the mouth and into the stomach, to guide the placement. The stomach is inflated with air to bring its wall closer to the abdominal wall, and the endoscope’s light helps identify the optimal insertion site.
A small incision is made in the skin, and a needle is passed through the abdominal wall into the stomach. A guidewire is threaded through the needle and pulled out through the mouth using the endoscope. The G tube is then attached to the guidewire, pulled through the stomach, and secured internally by a bumper or disc and externally by a retention device. This ensures the stomach remains flush against the abdominal wall to facilitate healing and tract formation.
Different Types and Practical Use
Gastrostomy tubes come in two forms: the standard long tube and the low-profile device, often called a “button.” Standard tubes extend several inches from the abdomen and are typically placed during the initial PEG procedure. Low-profile buttons are smaller, sit flush against the skin, and are preferred for long-term use due to their discreet nature and decreased risk of catching on clothing.
Low-profile devices require an extension set to be temporarily attached for administering feeds and medications. Management involves routine stoma care, including gently cleaning the site with mild soap and water daily to prevent irritation and infection. Users must also flush the tube with water before and after each use to prevent clogging and maintain patency for both bolus and continuous feedings.