If your gastrostomy tube is pulled or falls out please remain calm. Take a note of the time. You will need a new tube inserted as soon as possible, otherwise the stoma tract (hole through your skin) will start to heal and may close completely within a few hours.

Follow the instructions below to find out what to do next.

If you have a PEG tube (percutaneous endoscopic gastrostomy tube)

If your PEG tube has been pulled out, you will need to go to hospital to be assessed and have your tube replaced to avoid complications. Cover the stoma tract with a dressing, take your space tube – if you have one – and any information you have about your tube.

If you have a balloon gastrostomy tube (BGT) or low-profile balloon gastrostomy (LPBG or button)

If the balloon is inflated and you have pain, you will need to go to hospital to be assessed and have your tube replaced to avoid complications. Cover the stoma tract with a dressing, take your space tube – if you have one – and any information you have about your tube.

If the balloon is deflated and it’s your first tube in that stoma tract or if the tract is less than eight weeks old, you will need to go to hospital to be assessed and have your tube replaced to avoid complications. Cover the stoma tract with a dressing, take your space tube – if you have one – and any information you have about your tube.

If the balloon is deflated and it is not the first tube in that stoma tract and the tract is more than eight weeks old you can either:

• follow the instructions below to temporarily maintain your stoma tract and prevent it from closing, if you feel comfortable doing this
• contact your nurse, tell them what has happened and ask them to replace your tube urgently
• replace the tube yourself, if you or a carer have been trained to do this.

Maintaining your gastrostomy stoma tract on a temporary basis

Sometimes it is possible or necessary for you to place a new tube into the stoma tract, to prevent the stoma tract from closing, but not use the tube for flushing, feeding or medication. For example:

• you or your carer may be part way through learning the whole procedure of tube replacement and you feel competent to place the tube but not use it yet
• you may have been instructed by your healthcare professional that the risk of the stoma closing is greater than the risk of trying to keep the stoma open
• there may be no one available to replace your tube for two hours or more.

In these circumstances it may be best for you to gently place your replacement tube into your stoma tract.

1. Do not apply any force. Stop if you feel any pain, do not continue and seek medical attention.
2. Gently pass the tube* into the stoma tract just beyond where your tube normally sits.
3. Tape the tube down to your skin.
4. Do not use the tube. Do not flush with water, do not administer medications and do not feed via the tube.
5. Contact the person who normally replaces your tube or when possible, go to the hospital for a healthcare professional to manage the next steps.

*If you have a stoma stopper, such as Enplug, you could use this as an alternative to keep your stoma open.