2-4 weeks post-surgery: Most children will have a follow-up visit for a post-operative evaluation​

6-8 weeks post-surgery: Most children will have a follow-up visit to change out the button on their G-tube for the first time, known as a tube change. At this visit, families will be taught how to do tube changes at home, usually every 3-6 months as long as the G-tube is needed​.

Yearly: Visit with surgeon or gastroenterology team to assess tube and make any needed changes, children typically require larger tubes over time as they grow

**There may be different schedules depending on your hospital and care team​

School: Children can typically return to school within 3-5 days after surgery​

Swimming: Swimming is a great form of exercise and children with G-tubes can typically resume swimming within 2 weeks after surgery​

Other activities: Return to more strenuous activities, such as soccer or gymnastics may take longer, such as 4-6 weeks after surgery​, but you should discuss with your team how to keep your child’s G-tube protected during their preferred activity or sport.

When you and your care team agree your child no longer needs their G-tube, it can usually be removed in clinic. After removal, the area is covered with a dressing and usually the hole will close up on its own within 1 to 2 weeks, leaving a small scar.​ Sometimes the area where the G-tube was may not fully close and your child might need a surgical procedure to fully close it. ​

Dislodgement is when your child’s G-tube falls out or is accidently pulled out or “dislodged”. Long-term, tube dislodgement is considered a common G-tube complication, and most individuals will experience this complication at some point in time.

However, it is extremely important to keep the G-tube in place for the first 6 to 8 weeks after initial placement while the connection from the skin to the stomach heals. If the tube falls out or is accidently pulled out also known as “dislodged” during this healing phase it can be an emergency. If your child’s G-tube becomes dislodged during the first 6-8 weeks, you will need to contact your care team and will be advised to have your child evaluated in the hospital where medical professionals can replace it and be sure it is ready to use again for feeds.

After 6-8 weeks of healing, the tube will be changed out in clinic for the first time and you will be taught how to replace the tube at home. If your child’s G-tube becomes dislodged after this time, you will not need to be urgently evaluated if it goes back in easily.​

Leakage: All G-tubes have some degree of leakage of stomach fluid around the tube onto the skin. Some G-tubes leak more than others, but leakage is considered a common G-tube complication, and most individuals will experience this complication at some point in time.

Leakage may be a sign of a mechanical problem with the G tube, such as not enough water in the ballon, an opening that has become too big, or a tube that no longer fits correctly. Usually, the leakage is minimal and easily manageable, but if severe, can cause significant irritation to the surrounding skin.

Clogging: G-tubes can become clogged due to build up of feeds or medications. Clogging can lead to the G-tube not working properly. This complication can be typically be prevented by providing water flushes before and after feeds and as well as before and after medication administration. Your CF care team can provide tips for preventing clogging or make suggestions for different declogging methods.

A G-tube can cause pressure and irritation at the level of the skin, which can cause redness around the G-tube, known as dermatitis. If this occurs, it will typically improve with cleaning with warm soapy water and allowing the area to stay dry. Sometimes the skin will need a cream to protect the area.

If the redness spreads further outward from the G-tube or is tender to touch, it could be the sign of a skin infection, known as cellulitis. If an infectiond develops, you child may require an antibiotic you can place on the skin (topical antibiotic) or they may require oral antibiotics.

Skin irritation is considered a common G-tube complication, and most individuals will experience this complication at some point in time. Infection is less common and some individuals never experience this complication​.

Granulation tissue is new tissue that develops as a normal response to injury. The new tissue has a beefy or bumpy texture, hence the name "granulation" and will typically have tiny blood vessels that make the tissue appear pink.

Granulation tissue is not dangerous but can cause bleeding if it becomes irritated. It can be commonly be treated at home with a topical medication. At times it may require evaluation in clinic or surgical removal​.

Granulation tissue is considered a common G-tube complication, and most individuals will experience this complication at some point in time.

Gastroesophageal reflux (GERD) or reflux: GERD is the movement of stomach contents into the esophagus and is common among people with CF. Many people with reflux will continue to have reflux after G-tube placement or it could get worse, due to the stomach getting over distended with feeds.​ Reflux can increase the risk of aspiration, or fluid entering the lungs​ and will be something to address with your care team.

Bloating, Vomiting or Nausea: Bloating or nausea is commonly experienced with tube feeding, particularly in the morning for children who receive continuous overnight feeds. Some individuals may have increased vomiting from G-tube feeds. Your team can work with you to adjust your child’s feeding schedule to help address these symptoms. These side effects are considered common for children with G-tubes, meaning most children will experience these side effects while using their G-tube.

Diarrhea: All forms of tube feeding can cause diarrhea. Your team can work with you to adjust your child’s feeding schedule to help address these symptoms. While not uncommon, only some individuals will experience this side effect of G-tube feedings.

Many caregivers are worried a G-tube will make their child feel and look different than other children. A G-tube is attached to your child’s body and can be visible when not covered by clothing. However, under clothing no one would know your child had a G-tube. [Photo of a child wearing a shirt over a G-tube]. Many children, particularly as they get older, may prefer to always have their G-tube covered.

For most children, using the G-tube becomes a routine part of their care. For some kids, the G-tube can add anxiety about bumping or touching the G-tube area.

Most children typically experience weight gain and growth within a few months of consistent use of tube feeds. For some children this process may take a longer period of time.

Many families report that navigating sleep with a G-tube can be a challenge. While children can lay on their tummy with a G-tube, some children may find it uncomfortable lying on their bellies when they sleep due to the G-tube. For caregivers, they may have to wake up in the night to address the pump alarming or addressing tangled tubing. Often if children are active sleepers, they can accidently discontinue the tubing which can lead to formula leaking onto bedding. Many families suggest getting waterproof mattress covers to help protect bedding.

Once the G-tube site is healed, children with G-tubes can resume any of their preferred activities. Depending on the activity, such as those that may involve colliding with another person, you may be recommended to keep the G-tube covered to prevent dislodgement, or the accidental removal of the G-tube.

G-tubes are typically changed every 3 to 6 months due to tube wear or tear or breakdown that can increase leaking or cause the G-tube to accidently fall out. For most children, changing out their G-tube is easily done at home. For other children, it can be painful and difficult for families to change at home. This may mean you would need to be seen by your surgeon or gastroenterologist for G-tube changes in the office.

While a very uncommon complication of G-tube feedings, some children who receive tube feedings may lose interest or enjoyment in eating by mouth. Your CF team, and if needed a feeding specialist, can provide guidance to help ensure G-tube feeds help supplement what your child eats at meals or during the day.