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 as protected as possible.

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.​

All G-tubes have some degree of leakage of stomach fluid around the tube onto the skin. Some 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.

Usually, the leakage is minimal and easily manageable, but if severe, can cause significant irritation to the surrounding skin. Leakage may be a sign of another 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 does not fit.

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, 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​.
However, some people have experienced improvement in their reflux after G-tube placement.

Bloating, Vomiting or Nausea: Most people experience nausea or bloating with G-tube feeds, particularly in the morning after 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. Most individuals will experience this side effect of G-tube feedings at some point in time.

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. Only some individuals will experience this side effect of G-tube feedings at some point in time.

Possible causes:​

Medications​

Something is blocking the intestine​

Tube is not positioned correctly​

Tube feeding formula, rate or amount may not be ideal​

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What to do:​

Reduce the rate of tube feeding​

Space the tube feedings further apart​

Leave tube open to drain if nauseous​

Call your health care professional if nausea and vomiting prevent you from getting your full feedings for more than a day ​

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