Gastrostomy and Placement of G-Tube, J-Tube, or GJ-Tube
What is a gastrostomy?
A gastrostomy is a type of surgery to make a small opening through the skin into the stomach for a feeding tube. The opening is called a stoma. A feeding tube provides liquid nutrition, fluids, and medicines directly to the stomach or intestine.
The procedure to create the opening (stoma) is called an ostomy surgery. Types of surgically placed feeding tubes include:
Gastrostomy tube or G-tube, a feeding tube placed through the skin directly into the stomach
Jejunostomy tube or J-tube, a feeding tube placed through the skin directly into the small intestine (jejunum)
Gastrojejunostomy tube or GJ-tube, a feeding tube placed through the skin into the stomach and then extends to the small intestine (jejunum)
G-tubes, J-tubes, and GJ-tubes are inserted through a small opening in the skin called a stoma.
What to expect before the feeding tube placement
Before the procedure, your care team will go over what to expect and explain:
Why nutrition support is important and what type of feeding tube is best for your child’s needs
What to expect during the procedure
Possible risks and what problems to watch for
Fasting guidelines
Your child will have anesthesia for the feeding tube placement. Your child should not eat or drink anything by mouth, including candy and gum, for several hours before the procedure. This is called fasting. Your care team will tell you when your child should start fasting. You might also hear fasting called NPO. This is short for a Latin phrase that means “nothing by mouth." It is important to follow all fasting instructions from your care team.
What to expect during feeding tube placement
There are 3 main ways to place a feeding tube:
Image-guided (Interventional Radiology): X-rays and other imaging tests are used to help put the feeding tube in the right place. This is done in a special interventional radiology (IR) area.
Surgical: A feeding tube can be placed in the operating room, either through small cuts (laparoscopic) or a larger cut (open surgery).
Endoscopic (PEG): A thin instrument with a camera (endoscope) can be used to guide the tube.
The procedure your child gets depends on:
Their health and medical needs
Any other planned surgeries or procedures
What the hospital and care team can provide
Image-guided feeding tube placement
Special imaging tests can be used to help place a feeding tube in the stomach. This is called percutaneous radiologic gastrostomy (PRG). During the procedure, a live x-ray shows the stomach on a screen so the interventional radiology team can see what they are doing.
This procedure is done under general anesthesia and usually takes about 1–2 hours, including time in the recovery area.
Surgical feeding tube placement
Surgery to place a feeding tube is done in the operating room while your child is asleep under general anesthesia.
The surgery can be:
Laparoscopic (minimally invasive): Uses several small cuts and a tiny camera.
Open surgery: Uses a larger cut through the belly.
Laparoscopic surgery is preferred when possible, but open surgery may be needed if there is scar tissue or other medical issues. The procedure usually takes 1–2 hours, including anesthesia and time in the recovery area.
Percutaneous endoscopic gastrostomy (PEG)
PEG is a way to place a feeding tube using a special tool called an endoscope. An endoscope is a thin, flexible tube with a light and camera. The doctor puts it through the mouth, down the throat and esophagus, and into the stomach.
The camera shows the inside of the stomach on a screen so the doctor can place the tube in the right spot. The procedure is done while your child is asleep under general anesthesia and usually takes about 1–2 hours, including time in the recovery area.
What to expect after feeding tube placement
After the tube is placed, your child will go to the recovery area to wake up after surgery. Most patients stay in the hospital for 1–2 days. At first, your child will get clear liquids through the tube.
The tube will be held in place with tape or a special device. There may be gauze around the tube. Nurses will clean and change the gauze and tape as needed. You might see a little fluid around the tube for a few days. Your child may have some pain. Tell the care team so they can give medicine. Antibiotics may also be given to prevent infection.
Your care team will teach you:
How to care for the feeding tube
How to clean your child’s skin and care for the stoma. It is important to keep the tube and your child’s skin clean and free from infection.
What to do if the tube falls out or gets clogged. If the tube comes out, it needs to be replaced quickly because the stoma can close fast.
How to give formula, fluids, and medicine through the feeding tube
Problems to watch for
A dietitian will make a feeding plan, select the formula, and monitor your child’s growth and nutrition. Most children can go back to normal activities when they feel better.
After 6–8 weeks, the feeding tube may be changed to a smaller button or tube.
Risks of feeding tubes
Children usually do well with feeding tubes, but feeding tube placement does have risks.
During surgery, possible risks include:
Problems with anesthesia
Injury to nearby blood vessels, tissues, or organs
Problems with digestion, getting nutrients, or weight
Serious problems are rare. Follow all care instructions to help prevent infection and keep the tube working. Ask your care team if any medicines need to be changed after the tube is placed.
Care at home after feeding tube placement
Tips for caring for your child’s G-tube, J-tube, or GJ-tube include:
If your child has a feeding tube, such as an NG or G tube, it is important to take care of the skin around the tube. Learn skin care tips for feeding tube sites.
A feeding tube is a medical device that connects to the stomach or small intestine to provide nutrition support for children and teens who cannot take food by mouth. Nutrition given by tube feeding is called enteral nutrition.
