A gastrostomy tube (G-tube) is a medical device providing a direct pathway for nutrition, hydration, and medication. It is a form of enteral feeding, delivering sustenance directly into the gastrointestinal system when an individual cannot safely or sufficiently take nourishment by mouth. The G-tube bypasses the upper digestive tract, ensuring patients receive necessary caloric and fluid intake. It may be used temporarily or offer long-term support, significantly improving quality of life.
Defining the Gastrostomy Tube and Medical Indications
A G-tube is a flexible tube inserted through a surgically created opening, or stoma, in the abdominal wall directly into the stomach. The tube allows substances to be administered directly into the stomach, bypassing the mouth and throat. Designs include long, external devices secured by a retention disc or bumper, or low-profile “buttons” that sit close to the skin and require an extension set. The internal end uses an inflatable balloon or a fixed bolster to keep the tube securely in place.
G-tube placement is required for medical conditions that prevent adequate oral intake or pose a risk during swallowing. A primary indication is dysphagia (difficulty swallowing), often caused by neurological disorders like stroke or traumatic brain injury. Dysphagia risks aspiration, where food or liquid enters the airway, increasing the risk of aspiration pneumonia. The G-tube avoids this risk entirely by delivering nutrition directly past the pharynx and esophagus.
It is also commonly used for patients experiencing “failure to thrive” or severe malnutrition where oral intake is insufficient to support growth and development. Chronic diseases like cancer, cystic fibrosis, and metabolic disorders often increase caloric demands while simultaneously reducing the ability to eat by mouth due to fatigue, nausea, or obstruction. In such cases, a G-tube ensures the body receives the necessary nutrients and can also be used for gastric decompression to vent air or drain fluid from the stomach. The decision to place a G-tube is made when long-term enteral nutrition (four weeks or longer) is anticipated, as it is a more durable solution than a temporary nasogastric tube.
The Placement Procedure
G-tube placement is a surgical procedure performed under sedation or general anesthesia. The most common method is Percutaneous Endoscopic Gastrostomy (PEG), which is minimally invasive and performed by a gastroenterologist or surgeon. During PEG, an endoscope is passed down the throat into the stomach. Light from the endoscope helps the physician identify the optimal location on the abdominal wall for the stoma.
A small incision is made at the identified site, and the tube is passed through the abdominal wall into the stomach. The PEG tube is secured with an internal bumper and an external retention device, which keeps the stomach wall close to the abdominal wall to promote healing. Other methods, like laparoscopic or radiologically guided placement, are used when endoscopy is not possible, such as in cases of esophageal obstruction or prior abdominal surgery. Post-procedure recovery is relatively quick, with some patients returning home the same day following a PEG, though others may have a short hospital stay. The initial stoma site will be sore for several days, and full healing of the tract takes approximately one to two weeks.
Living with a G-Tube: Care and Quality of Life
Daily care of the stoma is essential for preventing infection and maintaining skin integrity. The area around the tube should be gently cleaned daily with warm, soapy water to remove drainage or crusting, then patted completely dry. The site must be checked daily for signs of irritation, such as increased redness, swelling, or unusual drainage, which may signal a complication. Tubes with an external bumper should be rotated slightly each day to prevent adherence to the skin.
Flushing the G-tube with water is necessary to prevent clogging and malfunction. This is done using a syringe before and after administering formula or medications, or whenever the tube has been used. Feeding is delivered in two primary ways: bolus feeding (larger volume over a short time, several times daily) or continuous feeding (slow delivery via an infusion pump over many hours). Medications must be properly diluted and administered separately, followed by a water flush to ensure they clear the tube.
A G-tube does not limit an active lifestyle, but precautions are necessary. Once the stoma is healed, patients can shower and bathe normally, ensuring the site is dried well afterward. Swimming is possible in clean water sources, but hot tubs should be avoided due to bacterial contamination risk. Contact sports like football or wrestling must be avoided due to the high risk of tube dislodgement or stoma injury. For other physical activities, securing the tube minimizes movement and reduces the chance of accidental removal or irritation.