There is a smaller tube the J-tube that will go into the jejunum via the same opening in the stomach wall, secured by the same balloon. There is a plastic disc around the tube outside of the child's body. This keeps the tube from sliding in and out of the opening. This plastic disc should not slide around on the tube, and should be snug against the skin the space between the bottom of the disc and the stomach should be about the depth of a dime , but it should not cause pressure.
The tube should be able to move in and out of the child's stomach just slightly. On the outside of the body, you will find three ports at the end of the tube labeled: gastric, jejunal and balloon. Your doctor or nurse will give you further instructions for their use. There are several different ways of securing a G-J tub. Your child's doctor or nurse will discuss these with you.
Here are some suggestions:. The following is an emergency problem that can occur with a G-J tube. For an emergency, take your child to the emergency room.
Before coming to the Emergency Room : If bleeding occurs, press on the site with a clean soft cloth. The opening in the stomach may close within hours, so it is important not to wait before coming to the Emergency Room.
When a G-J tube is replaced it is important to verify that the tube is in the right place, by taking an X-ray. Be sure to bring the tube with you to the Emergency Department. The following are non-emergency problems that can occur with your child's G-J tube. Discover how to vent a G tube, as well as other ways to manage fullness and bloating problems at home.
Gastrostomy tubes G tubes and gastrojejunostomy tubes GJ tubes are feeding devices. A G tube gives liquid nutrition, medication and other fluids directly into the stomach. A GJ tube gives liquid nutrition, medication and other fluids directly into the small intestine the jejunum. Both G tubes and GJ tubes are placed in a surgical opening in your child's tummy abdomen called the stoma. The tunnel from the outside into the stomach is called the tract. Venting a G tube means letting gas from your child's stomach out through the end of the G tube.
Venting before a feed allows air to escape the stomach before it is filled. Venting a child's G tube during or prior to feeds may also help with pain, discomfort or reflux associated with feeds. It may be scheduled as part of the child's daily routine or done on a PRN as needed basis. Factors to consider when choosing a method of venting may be:.
Whether routine or prn, assessments to make before venting may include:. Constipation can also be a factor in a child experiencing bloating and fullness. Vent only from the stomach, never the jejunum. Any G tube can be vented. For G tubes, when the plan is to vent, be sure to vent before starting a feed or giving medications. If the child's tube requires an extension set, this must be attached when you vent the tube.
Most children will have a care plan that includes intermittent scheduled or prn venting and some will require continuous venting for marked feeding intolerance. A G-J tube is a tube placed through the abdomen directly into the stomach and then passes into the small intestine also called the small bowel. Some children cannot tolerate feedings directly into the stomach and receive all of their feedings into the jejunal part of the small intestine where nutrients are absorbed. A G-J tube is a single tube that passes through the abdominal surface, into the stomach and down into the second part of the small intestine the jejunum see Figure 1.
The tube is made up of different sections: see Figure 1. A round plastic disk or flange around the tube, which should sit snugly against the skin so the tube, will not slide in and out of the opening. The tube should move in and out of the opening a little bit so it will not cause pressure to the area.
These are all clearly labeled and your nurse or doctor will give you specific instructions for their use. Figure 1. Carefully check the area around the tube once a day. Check for possible signs of infection such as redness, swelling, green or yellow drainage.
The area right around the tube may be slightly pink with some crusted drainage. This is normal. Clean the skin under the plastic disk and around the tube daily with mild soap and water or during bath time, unless your nurse or doctor instructs you not to tub bath. Then rinse the skin using clean tap water and dry completely. Please Note : If there is any crusted drainage on the skin, tube or disk, use quarter strength hydrogen peroxide on cotton swabs to remove.
Dry with a clean cotton swab or gauze. Check the length of the tube daily. If the length seems much more or less than usual it may have moved. Call your nurse or doctor to discuss what you can do and if you need to be seen or have an x-ray done to check placement. Do not turn or rotate a G-J Tube. This can cause an enlargement of the opening which may result in leakage of stomach juices onto the skin or possibly twisting of the tube itself. Stabilize the G-J tube securely so that your curious child will not be able to pull at the tube.
There are several ways to do this. Here are some suggestions:. Next wrap tape times around the tube above the plastic disk to stop the tube from sliding through the disk and into the stomach, which may result in blocking the stomach juices from emptying into the bowel.
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