It is important you carry your spare low-profile balloon gastrostomy tube (button) with you at all times to make sure your current tube can be quickly replaced should it fall out.

Cleaning your balloon gastrostomy tube

• Wash your hands, ideally with liquid soap and dry them with a clean towel or disposable paper towels before and after caring for your tube.
• Carefully clean daily around the gastrostomy site, under the external fixation device and around the tube with mild soap and water and a disposable cloth or gauze, rinse and dry well to reduce the risk of soreness and infection.
• You may have a shower, a bath or go swimming as the stoma has already been Please remember to cap off the end of the tube prior to these activities.
• Do not use creams or talcum powder near or around the stoma site to avoid the risk of irritation and breakdown of the tube.
• If the site is dry then no dressing is If there is a small amount of discharge around the stoma please ask your community nurse for a dressing.

Check the gastrostomy site daily. The following could indicate that the site is infected or the tube is displaced:

• oozing or odor coming from the site
• redness
• soreness
• excessive movement in and out of the gastrostomy

If you experience any of the above, please contact your community nurse or GP.

Checking position

Check the tube daily for excessive movement in and out of the stoma tract. If loose please check balloon inflation. If the tube feels too tight, digs into the skin or makes an indentation mark you may need a longer tube. This will then allow air flow under the external fixator. Please discuss this with us.

Tube rotation

It is important to rotate the low-profile balloon gastrostomy tube to prevent the tube sticking to the stoma tract and embedding in the stomach wall. This is called buried bumper syndrome and could result in a hospital admission.

Rotation

Rotate the tube through a full circle (360°) daily, to help develop the stoma tract.

Checking balloon inflation

It is essential to check the water in your low-profile balloon gastrostomy tube weekly to make sure the balloon has water in it and is not leaking or has perished. It is important the balloon is inflated with cooled boiled water as this holds your tube in position. Cloudy fluid, a significant reduction in the amount of water the balloon holds (please refer to manufacturer’s instructions regarding checking of balloon volume) or a very loose tube may indicate that the balloon has burst or is leaking and will need to be changed for a new tube. Please contact your community nurses for advice.

How do I prepare cooled boiled water?

1. Empty your kettle and fill using freshly drawn tap water from the drinking supply (avoid using water which has been boiled before).
2. Bring to the boil and allow the water to cool for no longer than 30
3. Pour into a clean Suitable containers include plastic jugs and bottles with lids.
4. Store on the top shelf of the fridge at 8°C or below, away from raw
5. Discard any unused water after 24 hours

Method

1. Use a 5mls luer slip syringe to draw up new cooled boiled water to be inserted into the
2. Hold the gastrostomy tube firmly in place throughout this check, and insert an empty 5mls syringe into the balloon valve.
3. Draw back with the syringe and completely remove all the water from the
4. Try a second time if necessary to remove all of the
5. Using the new syringe of water re-inflate the balloon by attaching the filled syringe to the balloon valve and gently pushing the required water into the

Please note: Never fill the balloon with air. If you are unable to carry out this check or any other aspects of tube care, please contact the Home Enteral Nutrition (HEN) Team or your community nurse.

Flushing your low-profile balloon gastrostomy tube

If you are not using your gastrostomy tube for feeding, please make sure you flush the tube at least once a day with fresh tap water to prevent the tube from blocking. Your dietitian will advise you on the amount required.

Method

• Wash your hands
• Place all the equipment you require on a clean surface, such as. 50 to 60mls syringe and measured water in a jug or cup.
• Make sure the position of the feeding tube has not moved by checking for excessive
• Attach a syringe of water to the extension set and fill set with water before attaching it to the low-profile balloon gastrostomy This prevents introduction of excessive air into the stomach.

1. Remove the cap from the end of your low-profile balloon gastrostomy tube.
2. Attach the filled extension set.
3. Remove the plunger from the syringe and attach it to your extension set.
4. Use your syringe as a funnel to slowly pour the correct amount of water into your feeding tube, keeping the syringe higher than the stoma site.
5. Clamp off the extension set and remove it and the syringe from the feeding tube and recap your tube.

or

1. Draw up the required amount of water into your syringe.
2. Remove the cap from the end of your low-profile balloon gastrostomy tube.
3. Attach the extension set to your balloon gastrostomy tube, then attach the filled syringe and slowly press down the plunger in the syringe to flush the water into the tube.
4. Clamp off the extension set and remove it and the syringe from the feeding tube and recap your tube.

• Try to remain upright for at least 30 minutes after a feed or flush to help prevent reflux and regurgitation.
• The syringe can be disposed of in your normal household.