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Emergency G-tube (Feeding Tube) Replacement

What is a G-tube?

A G-tube (gastrostomy tube) delivers liquid food through a small, hollow tube to your child’s stomach when they can’t take food by mouth. This is known as enteral nutrition.

The G-tube enters your child’s stomach through a small cut in the skin (stoma). The G-tube is held in place by a balloon filled with sterile water. The balloon rests inside the stomach. The balloon keeps the G-tube from sliding out of the body. A small disc rests outside the belly to hold the G-tube steady.

Gastrostomy Tube and Gastrostomy-jejunostomy tube

The G-tube enters the stomach through an opening in the body known as the stoma. The G-tube delivers liquid nutrition to your child when they cannot take food by mouth.

If your child’s G-tube is pulled out by accident, the stoma can close quickly. You must replace the G-tube right away. It is important to know how to replace the G-tube to keep the stoma from closing. Replace the G-tube only if you have been trained to do so.

Always follow the instructions.

Supplies needed

Supplies needed for a G-tube replacement

Make a kit with these supplies before an emergency happens. Always keep it with your child. Do not use expired supplies.

  • 2 catheters: 1 catheter the same size as your child’s current G-tube and 1 smaller catheter.
  • 1 G-tube the same size and length of the G-tube your child has now. 
  • 1 rubber band
  • 1 packet of water-soluble lubricant. Do not use other lubricants such as Vaseline®.
  • 1 (60 mL) catheter-tipped syringe
  • 1 (10 mL) slip-tip syringe
  • 1 packet of tape
  • 1 packet of sterile gauze dressing
  • Sterile or distilled water (do not use tap water)

How to replace a G-tube in an emergency

If the G-tube was placed less than 6 weeks ago:

  1. Step 1

    Step one: Wash your hands with soap and water for at least 20 seconds and dry them well. Or use hand sanitizer and rub until your hands are completely dry. Handwashing is an important step to help prevent infections.

  2. Steps 2 and 3

    Package of water-soluble lubricant

    Step two: Ask someone to help you hold your child's hands.

    Step three: Open the water-soluble lubricant and coat the end of the catheter that is the same size as your child’s current G-tube. Do not touch the end of the catheter that goes into your child’s body. The end of the catheter must stay sterile (free from germs).

  3. Steps 4 and 5

    Inserting the catheter into the stoma

    Step four: Gently insert the catheter into the stoma. Insert it to the same length as the G-tube stem length. Never force the catheter into the stoma.

    Note: If you cannot insert the catheter, coat the end of the smaller catheter with lubricant and try to insert it gently into the stoma. If this smaller catheter does not work either, go to the hospital right away to replace your child’s G-tube.

    Step five: Close the catheter you just placed with a rubber band to keep stomach contents from leaking out.

  4. Steps 6 and 7

    Taped catheter to stomach

    Step six: Tape the catheter to your child’s belly to keep it from moving.

    Step seven: Contact your child’s care team. Let them know that you have done an emergency replacement of a G-tube.

    Do not use the catheter for feeding. Your St. Jude team will replace the G-tube and provide further instructions.

If the G-tube was placed more than 6 weeks ago:

  1. Steps 1 and 2

    Step one: Wash your hands with soap and water for at least 20 seconds and dry them well. Or use hand sanitizer and rub until your hands are completely dry. Handwashing is an important step to help prevent infections.

    Step two: Ask someone to help you hold your child's hands.

  2. Steps 3

    Package of water-soluble lubricant

    Step three: If your child has a replacement G-tube, use it. Coat the stem with water-soluble lubricant. Open the lubricant packet, insert the stem (part that goes into the body), and coat it with lubricant. Do not touch the end of the G-tube that goes into your child’s body. It must stay sterile.

    If your child does not have a replacement G-tube, then use a catheter that is the same size as your child’s current G-tube. Open the lubricant packet, insert the end of the catheter, into the pack and coat it with lubricant. Do not touch the end of the catheter that goes into your child’s body. The end of the catheter must stay sterile.

  3. Step 4

    Step four: Gently insert the catheter into the stoma at the same length as the G-tube stem length into the stoma. If your child has a G-tube, insert the new G-tube in the stoma. Never force the catheter or G-tube into the opening.

    • If you put in a new G-tube: Inflate the balloon with the correct amount of sterile water using a slip-tip syringe. Use the amount of water that is provided by your care team.
    • If you cannot insert the same size catheter or G-tube: Coat the end of the smaller catheter or G-tube with lubricant and try to insert it gently into the stoma.

    Note

    If you cannot insert a catheter or a G-tube, go to the hospital right away. Your St. Jude care team will replace the G-tube and provide further instructions.

    Disc to hold the G-tube steady

  4. Steps 5 and 6

    Taped catheter on child's stomach

    Step five: Tape the catheter to your child's belly to keep it from moving.

    Step six: Check that the catheter or G-tube is in the correct position. Attach the 60 mL catheter-tipped syringe to the end of the catheter coming out from the body. Or, if your child has a G-tube, attach the 10 mL slip tip syringe to the feeding port on the G-tube. Gently draw the syringe plunger back and look for stomach contents (you may see baby formula, mucus, green drainage). If you can see stomach contents, the catheter or G-tube is inserted correctly. Stop pulling back on the syringe plunger.

  5. Step 7

    Taped catheter to stomach

    Step seven: Put a rubber band around the red catheter to close it. Or clamp the G-tube. You can apply sterile gauze to protect the skin around the stoma. 

    If you do not see stomach contents, go to the hospital right away. 

    • Apply a dressing if drainage leaks from the area.
    • Call your St. Jude care team to let them know you replaced your child’s G-tube or inserted a catheter. If you have questions, your child’s care team can help.

When to call your care team

  • If you cannot put a device in the stoma to keep it open, take your child to the nearest hospital or doctor’s office right away to have the G-tube replaced.
  • Call your care team when you have done an emergency replacement of a G-tube.

Key points about changing a G-tube

  • Make an emergency kit with all the supplies you need before an emergency happens.
  • Follow your care team’s instructions on how to do an emergency G-tube replacement. 
  • If you cannot keep the stoma open or insert a new G-tube or catheter, go to the hospital or doctor’s office right away to have the G-tube replaced.
  • Contact your care team if your child’s G-tube fell out and you replaced it. Do not use the G-tube for feeding until your care team can check to see if it is in the right place.

—
Reviewed: January 2024

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