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Your GP and Community Dietitian will be sent a letter informing them of the procedure you have had.
Your child’s PEG tube has been replaced with a low-profile gastrostomy-button (or G-button). Like a PEG-tube, you can feed your child or give medicine through a G-button.
Things to do at least once a day
An outpatient registered dietitian will call you before your feeding tube is placed. They’ll ask you if you’re able to use your mouth to eat, what type of food you eat, and how much you’re eating. They’ll also talk with you about your tube feeding plan. This will include the type of formula you should use and how you will manage your feeds. They’ll teach you how to give yourself the formula through your feeding tube. They’ll follow up with you 1 to 2 days after your feeding tube is placed. This is to make sure you received all of your supplies and are tolerating your feedings. Ask about your medications
Insert the lubricated balloon PEG into the stoma gently and it should pass freely without much resistanceBolus feedings (formula given over 10 – 20 minutes) and medications are given with a bolus connecter and a small slip-tip syringe. Boot levers are usually a rectangular piece of wood or plastic with a 'V' or 'U' shape at one end. They may assist you to remove your boots or shoes without bending down to hold the shoe or boot. To use a boot lever, place the heel of the boot or shoe into the 'V' or 'U' shaped end of the remover. Your other foot should then be positioned on the other end of the remover to hold it steady while you ease your foot out of the boot or shoe. Drawstring belts on pyjamas, trousers and skirts can be difficult to tie. Remove the drawstring at the waist and replace with elastic If you have nothing to put in the stoma, replace the old button and tape it down. This will keep the stoma open until you can seek medical attention. The doctors will have explained which type of GJ device they are planning to use when they are talking to you before the operation.
As many have a hook on the alternative end, they can also be used for reaching items of clothing, such as pants and trousers. Remove the water. The amount that should be in the balloon is on the top of the button or in the instruction book. As well as the risks of the general anaesthetic, formation of a gastrostomy can cause damage to the foodpipe, stomach or nearby structures. Careful measures are taken to manage these risks. If you are concerned about the risks to your child please discuss with the team performing the procedure.then factors to weigh include the size of the tube and the dexterity and body habitus of the patient. If the patient is interested in having a low-profile feeding tube then they, or their caregivers, must have greater dexterity to be able to manipulate the feeding tube connectors. A more active or younger patient may prefer a low-profile tube for lifestyle and cosmetic reasons. Commercially available PEG replacement tubes come in various combinations of standard vs. low profile with non-balloon vs. balloon internal bolsters in various length/ diameter combinations. The appropriate specific combination of external configuration, internal bolster type, and size/length can greatly improve function and quality of life for patients requiring PEG tubes. Generally, standard profile PEG tubes are placed initially and then can be replaced by low profile tubes at the first replacement or once the tract is matured. 4 The WHO of PEG Replacement Steenblik M, Hilden K, Fang JC. A retrospective correlation of percutaneous feeding tube stoma length in sitting and supine positions compared with body mass index. Nutr Clin Pract. 2012;27(3):406-9.
Lohsiriwat V. Percutaneous endoscopic gastrostomy tube replacement: A simple procedure? World J of Gastrointest Endosc. 2013;5(1):14-8.Misplacement into the colon can also occur. In this situation the initial PEG has been placed through the transverse colon into stomach. Often the initial PEG will function well, but upon exchange the replacement PEG is placed into the colon. Symptoms include pain, infection, feculent leakage, and diarrhea. Treatment is removing the misplaced PEG, waiting for the stoma tract to heal and placement of new PEG. 10 Other complications of PEG replacement include bleeding, pain, infection, and peristomal leakage. Peristomal leakage occurs more often in those with underlying medical conditions that predispose them to delayed wound healing. It is important to evaluate for other causes, such as tube displacement, buried bumper, and delayed gastric emptying. It is also important to minimize sideto-side movement of the PEG tube where it exits the skin as that can enlarge the tract. This can be accomplished by changing to low profile tube or external stabilization with a right-angle bumper or clamp. Good stoma care with zinc oxide-based protectants and consult to wound An anaesthetist will also see you to explain the anaesthetic in more detail. If you have any medical problems, like allergies, please tell the doctors. If you had a low profile balloon button GJ device inserted, you will usually be able to start using it for fluids and feeds straightaway This tube is placed if an old PEG has fallen/pulled out and there is a well formed and matured tract
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