A gastrostomy tube, commonly known as a G-tube, is a medical device designed to deliver nutrition, fluids, and medication directly into the stomach, bypassing the mouth and esophagus. This method of feeding, called enteral nutrition, is used when a person cannot safely or sufficiently take in nourishment. The G-tube ensures individuals who have difficulty swallowing or absorbing nutrients receive the necessary calories and hydration.
Defining the Gastrostomy Tube
A G-tube is a flexible, hollow tube inserted through a small opening in the abdominal wall. This opening in the skin is called a stoma, and it serves as the pathway for the tube. The tube is held securely inside the stomach by an internal retention mechanism, such as a water-filled balloon or a soft, dome-shaped bumper.
On the outside of the abdomen, an external retention device keeps the tube from slipping inward. G-tubes come in two main forms: standard tubes, which are longer and secured with an external clamp, and low-profile tubes, often called “buttons”. The button type is shorter and sits flush against the skin, requiring a separate extension set to administer feedings or medications. The G-tube provides a reliable, long-term route for supporting nutritional needs.
Primary Medical Applications
The most frequent reason for placing a G-tube is to provide nutritional support when oral intake is impossible, insufficient, or unsafe. A major category of use involves conditions that impair the ability to swallow safely, a problem known as dysphagia. Neurological disorders, such as stroke, cerebral palsy, Parkinson’s disease, or amyotrophic lateral sclerosis (ALS), can weaken the muscles controlling the swallow reflex, significantly increasing the risk of aspiration. By bypassing the upper airway, a G-tube minimizes this life-threatening complication.
Another primary application is for individuals with conditions that prevent them from consuming enough calories to maintain weight and grow properly, a state referred to as “failure to thrive”. This can be due to physical or developmental challenges, or chronic illnesses like cystic fibrosis or congenital anomalies. In these cases, the G-tube is used to supplement oral feeding, ensuring adequate protein, fat, and total caloric intake.
G-tubes are also routinely used in patients undergoing treatment for head, neck, or esophageal cancers, where the disease or its treatment, such as radiation therapy, can obstruct the passage of food or cause severe pain. Beyond nutrition and hydration, the G-tube is an effective route for administering necessary medications, which are typically crushed and mixed with water before being pushed through the tube. Some G-tubes can also be used for gastric decompression, which involves removing excess air or fluid from the stomach to relieve symptoms like bloating, nausea, and vomiting.
The Placement Process
The insertion of a G-tube is a medical procedure typically performed under sedation or general anesthesia. One of the most common techniques is Percutaneous Endoscopic Gastrostomy, or PEG. In this method, a physician inserts a flexible tube with a camera, called an endoscope, down the throat and into the stomach.
The endoscope allows the doctor to visualize the stomach lining and guide the procedure. Using the light of the endoscope to illuminate the abdominal wall, a small incision is made, and the tube is passed through the skin and directly into the stomach. The internal bumper is then secured against the stomach wall, and an external disc is placed on the abdomen to hold the tube in its final position.
Alternatively, the tube may be placed using surgical methods, such as laparoscopic or open surgery. Laparoscopic placement involves smaller incisions and the use of a laparoscope to guide the tube. Open surgery, which uses a larger incision, is reserved for situations where other methods are not suitable, such as when other abdominal surgery is required. The procedure is considered a minor surgery, and some individuals can return home the same day.
Daily Life and Management
Living with a G-tube requires careful daily management to prevent complications and ensure the device functions correctly. The most important aspect of care is maintaining the cleanliness of the stoma site. This area should be gently cleaned daily with mild soap and water, then patted completely dry to prevent skin irritation and infection. Caregivers should look for signs of infection, such as increased redness, swelling, warmth, or unusual discharge.
Flushing the G-tube with a small amount of water is another routine task performed before and after every feeding and medication dose. This action is essential for preventing the tube from becoming clogged with formula or crushed medicine residue. If a tube does become clogged, gentle flushing with warm water is often the first step in troubleshooting, with a call to the healthcare team if it persists.
Feedings can be administered through two common methods: bolus or continuous. Bolus feeding involves giving a set amount of formula over a short period, typically using a large syringe, which mimics the timing of traditional mealtimes. Continuous feeding uses an electronic pump to deliver smaller amounts of formula slowly over several hours, often overnight. If the tube accidentally comes out, the stoma can close rapidly, so immediate medical attention is necessary to replace the tube within hours.