A G-tube (gastrostomy tube) is a hollow, flexible medical device inserted through the abdominal wall directly into the stomach. Its primary function is to provide a safe path for delivering nutrition, fluids, and medication when a person cannot eat or drink enough by mouth. This form of long-term enteral access uses the gastrointestinal tract to supply necessary calories and hydration. G-tube placement is necessary when a person’s ability to swallow is compromised or when oral intake is inadequate to meet nutritional requirements.
Anatomy and Mechanics of a G-Tube
G-tubes are designed with specific components to ensure they function properly and remain securely in place. The tube material is typically flexible silicone, which is gentle on the body and intended for long-term use. There are two main categories: the standard-length tube and the low-profile device, often called a “button.”
Standard tubes are longer, with visible tubing extending outside the body, secured internally by a balloon or a retention bolster (internal bumper). The external end features an access port where syringes or feeding sets connect to administer formula or flush the tube. Low-profile buttons, conversely, sit flush against the skin, offering a less noticeable and more comfortable option.
A button device requires a detachable extension set for feeding or medication administration, which is removed when not in use. Both types utilize an internal retention mechanism, such as a water-filled balloon, inflated inside the stomach to prevent tube dislodgement. The tube’s design allows for the safe passage of liquid nutrition and dissolved medications directly into the stomach, bypassing the mouth and esophagus.
Medical Conditions Requiring Tube Feeding
A variety of conditions necessitate G-tube use, generally related to impaired swallowing, anatomical blockages, or severe malnutrition. Neurological impairments are a common indication, as conditions like stroke, ALS, or traumatic brain injury can compromise the swallowing reflex (dysphagia). When swallowing is unsafe, there is a risk of aspirating food or liquid into the lungs, which G-tube placement helps prevent.
Anatomical issues in the upper digestive tract, such as blockages or narrowing of the esophagus due to head or neck cancers, can prevent adequate oral intake. In these cases, the G-tube provides a bypass to deliver nutrition beyond the obstruction. A G-tube is also necessary for individuals experiencing severe malnutrition or “failure to thrive” who cannot consume sufficient calories orally.
The Tube Placement Procedure
G-tube placement, known as a gastrostomy, is most commonly performed using Percutaneous Endoscopic Gastrostomy (PEG). This minimally invasive method uses an endoscope, a flexible tube with a camera, guided down the throat into the stomach. The endoscope allows the physician to visualize the stomach lining and guide the tube placement from the inside. Once the optimal location is identified, a small incision (stoma) is created through the abdominal skin. The tube is then secured inside the stomach with a retention bumper or balloon.
The PEG approach is preferred because it avoids major open surgery, often requiring only conscious sedation or light anesthesia. Alternative methods are used when PEG is not feasible, such as with upper gastrointestinal obstruction or prior abdominal surgery. These include laparoscopic gastrostomy, which uses small incisions and specialized tools, and traditional open surgery. The immediate recovery involves close monitoring for the first few days, with feeding typically starting soon after the procedure.
Caring for the Site and Tube
Maintaining the G-tube and stoma site requires a consistent daily routine to prevent infection and complications. The skin around the stoma, where the tube enters the abdomen, should be cleaned once or twice daily with mild soap and water. Gently clean the area in a circular motion, moving away from the tube, and then pat it completely dry.
Flushing the tube with water is necessary before and after every feeding and medication administration to prevent clogging. Typically, 10 to 20 milliliters of water is used, ensuring no formula or crushed medication residue remains inside the lumen. If the tube becomes clogged, warm water or a specialized acidic solution may be used to dislodge the obstruction, though forceful pushing should be avoided.
Troubleshooting common issues is part of managing a G-tube, with leakage around the stoma being a frequent concern. Leakage occurs if the internal balloon is under-inflated or if the stoma tract has stretched, requiring a check of the balloon’s water volume. Granulation tissue, which appears as moist, bumpy, reddish tissue, can form around the site due to chronic irritation. This tissue may require specific topical treatment from a healthcare provider.
Feeding can be delivered in two primary ways: bolus feeding, which administers a larger volume of formula over a short period several times a day, or continuous feeding, which uses a pump to deliver smaller amounts over many hours. Regardless of the method, the tube’s external position should be checked daily by measuring its length. This confirms the internal bumper or balloon remains correctly seated against the stomach wall.