g-tube tips

March 13, 2002

[Tips Picture] G-Tube Tips

Our daughter had terrible granulation tissue before someone told us about

eucalyptus oil. We now use it everyday and have no build-up around the

tube. It will also bring down the tissue. It has to be diluted: 2 drops of

oil to 10-20 ml. of water. I swab it around the tube area with Q-tips. You

may want to test it on another area first to be sure there will not be an

allergic reaction. For my daughter, it worked wonderfully. I know of lots

of other parents who have also tried it and had very good results. No more

silver nitrate burns! I would recommend trying it. The oil can be bought at

health stores or off the Internet. - L.J., city and state unknown

My daughter has had a G-tube for about five years. Her nutrition is solely

from her G-tube feeds. I use a creme around the site that’s called

Calmeseptine. It's fairly new on the market and works very well for that

area. I put the creme on 3 times a day and then cover it each time with a 2

x 2 gauze. My daughter very rarely has any problems with granulation or

infection by the G-tube site. - J.K., city and state unknown

To clean the G-tube, pour flat Coke/cola through the tube. It works

wonders. Also to prevent leakage and skin irritation, use 4 x 4

tracheostomy drain sponges. They can be purchased at many drug stores. -

D.T., Kenner, LA

We try to make our son's feeding bags last a few days, but to avoid

bacterial growth, we refrigerate the bag between cleanings. Works for food,

and for food bags! - K.H., Rockford, IL

My son had horrible problems with granulation tissue around his G-tube

since the day it was placed. We were using silver nitrate every 2 to 4

days. We tried creams, antacids, Cholestin, and IV sponges, but none healed

him. Someone told us about foam dressings. It worked! My son's G-tube site

has been healed for the first time in 4 years! The brand name is called

Hydrasorb. It is a foam dressing, and it absorbs any leakage and it cuts

down on the scar tissue. It took about two months to fully heal while using

this dressing, but his stomach is now dry and tight and the scar tissue has

lessened. Try it! - D.M., Traverse City, MI

I have a 16 year old daughter who has cerebral palsy, is non-verbal and is

G-tube fed. I have found from my life experience that there are not a lot

of products on the market to help with different situations. So I have

taken in hand, marketing different products to help. One is called the " GT

Pad. " I use to spend approximately $150 Canadian per year on gauze for her

site, not including the prescriptions to help clear up problems. I have

been using " GT Pads " for 4 years and am very happy with them and the money

I have saved. I have found ten pads can last up to two years. - J.G.,

Medicine Hat, Alberta, Canada

We've found that, in addition to putting a 2 " x2 " split sponge between the

skin and the button, using Silvadene cream regularly is the most effective

way to keep the site mostly irritation-free.

Also, the best tape ever to hold the gauze against the skin (or an NG-tube

to the cheek, or a nasal cannula) is Hypafix dressing retention sheet tape.

The adhesive is very sticky, but doesn't hurt when pulled off, and it's

hypoallergenic. The fabric is pliable and doesn't poke and it does need

scissors to be cut. Most hospitals don't know about it, so you should ask

for it to be ordered.

Bolus-feeding: when my son needed to be bolus-fed or vented with a 60cc

barrel, we attached velcro to the barrel, and the corresponding piece to

his feeding chair. For travel, we attached the corresponding piece to his

car seat and his stroller. - L.S., Altadena, CA

My daughter, Marissa, has a G-tube and we have gone through the same

horrors of granulation tissue as a lot of you. Marissa just recently had to

have surgery to remove this tissue as the silver nitrate did not help. I

received a good tip from a friend of mine on the G-tube network: simply

place a makeup square or round under the tube. I have to cut a slit in it,

but it fits great under the " peg. " It was tried by many and seems to work

miracles with preventing the tissue from growing back. - T.S., Glens Falls, NY

My daughter is 2 ½ years old. She has been on continuous feeds since she

was 13 months old. I found a great way to keep her G-tube from coming out

at night and at play. Take the tube and snake it through her diaper. Make

sure to leave enough slack between her diaper and the button. To do this

before I really had the system down, I would stand her up. The best diapers

to use are the cheap ones with the tape; the Velcro ones don't keep the

tube in place as well. - Initials, city and state unknown

Silver nitrate is needed for our child to keep granuloma in check. However,

we find the nitrate can discolor and irritate the adjacent skin. Petroleum

jelly or other such substance (we use an anti-bacterial jelly called

Bactraban) can help protect this area of the skin surrounding the tube

site. What also helps is to keep our daughter flat for awhile after

application of the silver nitrate. My understanding is that the nitrate

reduces the granuloma a bit, which may permit gastric oozing, causing the

nitrate stains. - J.D., Haverford, PA

My son had a G-tube for years before I figured out the best way to clean

the connector tubing. All you need is water and a table knife. WHILE YOU

ARE RUNNING WATER THROUGH THE TUBE, hold the tube between your thumb and

the dull side of a table knife, and act as if you were curling a ribbon on

a birthday present. Press the tube hard between your thumb and the knife

and run the knife/thumb the full length of the tube, in the direction that

the water is flowing. The pressure of the " ribbon curling " action will

loosen all the gunk, and the water carries it away. It takes 10 seconds,

and it works on all tubes, even tubes too small for a pipe cleaner. This

method also unblocks plugged tubes. - D.M., Traverse City, MI

To keep tubing from crimping at night due to rolling, I took an old toddler

size sock, cut off the toe end, feed the tubing thru it and put it on his

leg. This keeps the tubing in a general area and stops it from crimping. I

have also heard of using a wrist sweatband. - T.H., Hilliard, OH

I stumbled on this site after my son's G-tube was removed, but kept the

address. It is a great site for new or old G-tube users or people dealing

with a loved one that has one: www.iinet.com.au/~scarffam/gtube.html. As

far as traveling with my son, who by the way was a continuous G-tube

feeder, it was very difficult until I got the hang of it. I made a hook out

of a coat hanger for the bag to hang on and put it on the handle above the

door with the pump on the floor. After stabilizing the pump, we were ready

to ride. It is a process that takes practice getting from the house to the

car and back again, but it can be done. I got tired of being home thinking

I needed someone to help us go some place - being dependent on someone

else's schedule. So, I experimented when I did have help, just in case I

needed an extra hand to figure it out. Now, my son is fed by mouth only,

and the G-tube was removed in December '98. Everyone isn't as lucky as we

are, but if I can help one person out there with our quirky ways of doing

things, I have accomplished more than I realize. - C.M., city and state unknown

Try putting a coat of clear nail polish over the numbers on a syringe to

prevent them from washing off. - R.B., Calgary, Canada

For those of you crushing vitamins, I have a better solution. I crushed

them for years until one day I decided to try placing the vitamin in a

little medicine cup and adding about 10cc of water. The next morning, the

vitamin is dissolved and needs no crushing. - J.P., city unknown, SC

My seven year old with HD used to have a G-tube, but this was replaced by a

button (which is heaven sent). The button is so much easier than the tube

and there is no bulk. It is pretty much flush with the skin. We do have a

problem with the button leaking though. We use split two by twos to put

under the button (2 packages). This makes the button a little tighter and

helps to control leaking. I put a piece of tape across the gauze to keep

the button closed during the day. - Initials, city and state unknown

For granulation tissue around the G-tube site, our doctor has prescribed

Carafate suspension. We use a Q-tip to dab this on 2-3 times a day; this

works really well. We also clean the site with normal saline (not the kind

used for irrigation, but the kind used for cleaning) which is available

over-the-counter in a large bottle (which lasts a long time). My 16 year

old son has had a G-tube for about 9 years, so we have tried many remedies,

but these work the best for us. There is also a very good multi-vitamin

available in liquid form that we have used for years. It is Vi-Daylin, and

is over-the-counter, but the pharmacy usually has to order it in. - B.S.,

Opelika, AL

I have found that using gauze around the G-tube works well to prevent

irritation and granulation tissue as well. To avoid having to have scissors

handy to make the ½ cut, I found that 2x2 I.V. split gauze works great! -

C.C., Milwaukee, WI

For those who don't want to go through all the hassles of crushing

vitamins, we have found that Shaklee makes a water soluble vitamin powder,

called Vita-Lea. It dissolves readily and stays in suspension pretty well.

The directions suggest mixing a teaspoon with several ounces of water,

which can be a lot of additional fluids to administer. We use a smaller

amount of water to mix the vitamins, and follow each syringe-ful with a

plain water chaser, to keep the tube clear. - B.R., Forestville, CA

Our son is G-tube fed and has had lots of trouble with granulated tissue.

We tried everything - cortisone cream, Destin (allergic) and silver nitrate

- but nothing seemed to work. We started putting 2x2 gauze, cut in the

middle, with Maalox on the area around the tube. By cutting the gauze, you

can fit it around the tube next to the skin. This will leave the G-tube

site open to connect to the pump. He has not had anymore granulated tissue.

This is easy for us and painless for him. At the first sign of irritation,

we get the Maalox out. - R.H., Cookeville, TN

When mixing medications for G-tube use, dilute the medication with a small

amount of fairly warm water and when the medication is dissolved enough,

add a small amount of cool water to make it a comfortable temperature. Most

medications will dissolve well this way. - L.A., Colts Neck, NJ

To clean the extension sets for G-tubes, use extra-long pipe cleaners and

hot soapy water. The long pipe cleaners can be bought in craft supply

stores and work really well to remove the build up from inside the tube. -

M.O., Ontario, Canada

A caution on the use of cortisone cream to treat granulation tissue:

cortisone should only be used on an " off-again, on-again " basis, as it is a

steroid, and can, over time, cause the skin to become thin and weak. Used

three days on, three days off is reasonable. Used only on an " as-needed "

basis is best. It is also great to combine cortisone cream with an

over-the-counter antibiotic ointment (e.g., Bacitracin) and an antifungal

cream (e.g., Lotrimin). This triple-combination approximates a commercial

product called Kenalog cream (triamcinolone), which is popularly

recommended by many parents on the G-tube mailing list. - S.G., Sudbury, MA

My daughter, who is G-tube fed, needs to take a multivitamin with minerals.

The best ones I have found are the Bugs Bunny brand. They are sugar free

and crush much easier than the others I have tried. Another plus is that

they are cheaper and a child under 4 only has to take ½ of one instead of a

whole one! - J.J., Denton, MD

I use the wooden end of the long Q-tips to clean the extension tube to my

son's G-tube. I just put in a drop of soap and then rinse well. Also, once

a week, I soak it in 1/2 strength vinegar and then wash. - T.H., Hilliard, OH

Our son has a G-tube and has had problems with granulation tissue. I have

found that cortisone cream shrinks the granulation tissue, and Desitin

heals the irritation. Works wonders for us. - D.B., Dubuque, IA

For those of you who need to crush pills to put in a G-tube, I highly

recommend a syringe by Nestle called the HandiCrush. You place the pill in

the crusher and put in the plunger. One turn and the pills are crushed.

Then, you suck up water or whatever to mix it. No more trying to get a

little bit out of the medicine cup. - T.R., Dickinson, ND

Our daughter has a G-Button that continually leaks due to granulation

tissue. We have tried silver-nitrate and that didn't seem to help. So we

took a disposable nursing pad and folded it into fourths and cut the corner

off, leaving a hole in the center. We then cut two vertical lines opposite

of each other. We clean her button, dry it, and put Desitin under it. Then

we gently ease the nursing pad over the button and underneath it. It

collects all of the moisture and draws it away from her skin. It stays in

place all day or night. I am pleased to say, the granulation tissue has all

but disappeared on its own! - K.T., Avon, IN

Recently, we took our 15 month old daughter, who is G-tube fed, on a trip

to Australia to visit her grandparents. She gets a bolus feeding every few

hours, so we have to take her tube and syringe with us, whenever we venture

out. I had tried wrapping them in paper towels and putting them in her

diaper bag. They usually ended up unwrapped and at the bottom of the bag or

worse yet, on the ground, after we had rummaged through the bag a few times

- yuck! We found a travel case in K-mart for a toothbrush and toothpaste

that fit perfectly. If you detach the tube from the syringe, they lay on

top of one another! Now you have a wonderful G-Tube travel case. - K.T.,

Avon, IN

Do you have a great idea that you can share with others? Please send us

your tips to Tips@.... All letters will be printed with your

initials, city and state.

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