Your health care professional suspects that the internal bumper – which secures your gastrostomy tube in your stomach – has become attached to your stomach lining. This is known as buried bumper and may stop your tube working properly.

It is important for buried bumper to be investigated so a doctor can share treatment options with you. This usually means you will need to attend a hospital appointment and possibly undergo a gastroscopy procedure – where a tube is used to look in your stomach from the inside – to identify any internal problems with your gastrostomy tube. Sometimes, while you are waiting for an appointment or for treatment, the doctor may decide it is safe for you to continue to use the tube.

If you have been told by the doctor that you can continue to use the tube, there are a few things you need to know.

You will need a personalised care plan from the doctor, telling you it is safe to use the tube and how you may use the tube. This care plan includes guidance on:

• when you might need to seek medical advice and stop using the tube, for example if you have any pain when feeding or flushing the tube, there is swelling or leakage of feed around the tube onto your skin
• whether you can have your usual feed, water flushes and medicines, if you take any, via the tube. The hospital may also talk with your dietitian if any changes are needed
• signs to look out for which might indicate a serious infection which needs treating, for example if you feel unwell, have a temperature – or feeling of temperature – or have pain, redness or heat in your skin around your tube.

Always tell the doctor if you have any concerns about feeding through your tube with the buried bumper, especially if flushing or feeding becomes more difficult or if you show any of the signs or symptoms above.

The doctor will usually plan with you to replace your gastrostomy tube. After your new tube is placed, follow all the care instructions. Make sure the Home Enteral Nutrition Team knows you have a new tube, so a new care plan can be put in place to try to reduce the risk of another buried bumper.