Feeding Tube Insertion: Gastrotomy

We all know stomach rules the mind. Eating food is not just eating energy, it is an experience. Long use of certain medicines or some other conditions might hinder our sense of taste. This condition is generally temporary. But if you have trouble swallowing or can’t drink enough through your mouth, you may need a feeding tube. You may get one through your nose or mouth for a few days or weeks while you recover from an illness. Read on to know about Feeding Tube Insertion / Gastrotomy.

Conditions that may require Feeding Tube Insertion( Gastrotomy)

• Stroke
• Burns
• Cerebral palsy
• Motor neuron disease
• Dementia

What is Gastronomy?

Gastrostomy is the placement of a feeding tube through the skin and the stomach wall. It goes directly into the stomach. It’s used to supply nutrition when you have trouble eating.

Alternate names:

Feeding tube insertion is also called percutaneous endoscopic gastrostomy (PEG), esophagogastroduodenoscopy (EGD), and G-tube insertion.

Gastronomy procedure:

A gastrostomy feeding tube (G-tube) is inserted with the help of an endoscope. Endoscopy gives an inside view of the body. It used a flexible tube with a small camera on the end of it. The endoscope is inserted through the mouth and down the esophagus, which leads to the stomach.

Numbing medicine may be sprayed into your mouth to prevent the urge to cough or gag when the endoscope is inserted. A mouth guard will be inserted to protect your teeth and the endoscope.

This procedure requires you to fast for almost 8 hours. After the endoscope is placed inside, the skin above the stomach is cleaned and numbed. The cut is made on this area for insertion of the tube. The tube is small, flexible, and hollow. The feeding tube is secured and place a sterile dressing around the site. There may be a little drainage of bodily fluids, such as blood or pus, from the wound. The whole procedure usually lasts less than an hour.

This feeding tube can be temporary or permanent, depending on the primary reason for the feeding tube.

Care to be taken after the Feeding Tube Insertion (Gastrotomy):

• Rest till the wound heals
• Get your dressing changed regularly till the tube oozes some fluid
• Keep the area of gastronomy dry and clean to avoid skin irritation or infection

Why do we need gastronomy?

This treatment is reserved for when you have trouble eating on your own, due to reasons such as the following:

• You have an abnormality of your mouth or esophagus: It is the food pipe that connects your throat to your stomach. It can be inflammation or tumors or any removal surgery.
• You have difficulty swallowing or keeping food down: This can be a muscle defect of the food pipe.
• You aren’t getting enough nutrition or fluids by mouth: The food ingested is not enough according to the required calories.
• Birth defects: Babies with birth defects of the mouth, esophagus, or stomach, For example, oesophageal atresia or tracheal oesophageal fistula.

Points to keep in mind before opting for Feeding Tube Insertion ( Gastrotomy):

The doctors need to know all the medical conditions you have along with the medicines you take. Mention if you take any blood thinners, aspirin, or clopidogrel. These blood thinners need to be stopped a week prior to the procedure. These medications can lead to excessive bleeding while making cut on the skin.

Other essential conditions the doctor should know are:

• If you are pregnant
• Do you suffer from diabetes?
• Do you have any food or medication allergies?
• Any heart conditions
• Any lung conditions

Risks factors involved with Feeding Tube Insertion ( Gastrotomy)

• Trouble in breathing and nausea from the medication
• Excessive bleeding in or around the stomach area
• Infection at the insertion site

When to reach a doctor after gastronomy?

• The tube comes out
• If the tube is blocked with food particles
• There is bleeding around the tube insertion site
• There is drainage around the site after several days
• You see signs and symptoms of an infection like redness, swelling, or a fever

When does the cut around gastronomy heal?

The stomach and abdomen will heal in 5 to 7 days. There can be slight to moderate pain that can be treated with medicine.

What feeds do we give when we have gastronomy done?

Feedings gradually progress from clear liquids to full liquids.

Examples of Clear liquids:

Water, dal and rice water, strained fruit and vegetable juices, vegetable or chicken stalk.

Examples of full liquids:

1. Commercial feeds: Supplements mixed with milk, soy milk, buttermilk, curd, or water
2. Homemade Formula: Crushed cooked food, vegetable paste, thin khichdi, minced chicken, crushed dal rice, etc.

Advantages of the commercial formula:

• Easy to use
• Readily absorbable
• Have minimum residue
• Accurate nutrients as mentioned on the cover
• Travel friendly

Disadvantages of the commercial formula:

• Expensive
• Chances of getting damp if not stored properly

Advantages of the homemade formula:

• Cost effective
• Mental satisfaction of having a favorite food
• Choice of ingredients to select
• Innovative feeds

Disadvantages of the homemade formula:

• Time consuming
• Chances of clogging the tube
• Hygiene can be the concern
• The consistency might vary each time
• Not travel friendly
• Absorption and availability of nutrients is unknown

Maximum quantity and time of the feed:

Depending on the calories required and the disease condition, the doctor and dietician decide the quantity of each feed. It can vary from 150 ml to 300 ml per feed. The frequency of the feed can be every 2, 3, or 4 hours. In total there can be a total of 3 to 8 feeds throughout the day.

How to clean the feeding tube after feeding?

After the feed is passed from the tube, pour 50 to 100 ml sterilized water through the tube. This cleans the remaining food particles in the tube and prevents clogging.

Endnote:

A gastronomy feeding tube enhances the quality of the life of the patient who has difficulty swallowing food. Take the right decision at the right time for its maximum benefits. A perfect blend of commercial and homemade feed will provide all the required nutrients and make life easier.

Read – Indian diet plan for fatty liver, Indian diet plan for gall bladder removal.