Under the drip-feeding method, feedings are usually performed every four to six hours. Clogging of tubes is regularly reported, especially in small-bore tubes. Tubes should be flushed with water before and after feeding during intermittent delivery, and every 4 to 8 hours during continuous feeding. This is done with a syringe full of water which is attached directly to the tube. Multiple flushings with the syringe will ensure a free-flowing system.
The patient may experience bloating either before or after feeding. If this occurs, the stomach and intestinal tract should be decompressed. Removing the adapter feeding cap from the tube and allowing the PEG to be open to air can easily accomplish this. Encouraging the patient to cough will also facilitate decompression. The lifespan of the feeding tube is about six months. When the tubing begins to wear, it may pull away from the stomach wall and cause leakage near the insertion point.
The replacement process is relatively simple and usually does not involve another endoscopic procedure. Typically, the tubing is merely pulled out through the stomach site and then replaced with a new catheter. Complications to this therapy may occur, but the likelihood is slight, with only a one percent chance of major problems gastric hemorrhage, peristomal leakage and an eight percent chance of minor ones infection, stomal leaks, tube extrusion or migration, aspiration and fistula formation.
Aspiration is perhaps the most common complication related to tube feeding. This occurs when food is actually inhaled into the lungs. Aspiration can lead to pneumonia, but if the patient is kept upright during feeding, the likelihood of developing this complication can be greatly minimized. The best way to deal with clogs in the feeding tube is to not get a clog in the first place. This is why it is always important to flush the tube with plenty of water before and after feeding.
Also, make sure all medications are completely crushed. Tubies have frequent problems with reflux medicine like Prevacid or Nexium getting stuck in the tube. These meds are normally tiny balls packed in capsules and the balls often clump together in narrow passages like feeding tubes. The best way to take this type of medication is to suspend the tiny balls in something thicker than water.
Applesauce works very well for this and can be pushed through the tube fairly easily. Another preventative measure for clogs is to make sure your food is well blended.
Commercial formulas are designed to easily flow through feeding tubes, however blended meals need to be blended with a high-end blender, like a Vitamix or Blendtec, or strained before they are put into the tube see the section on Homemade Tube Nutrition.
If a clog does occur, there are simple steps you can take to try to clear out the obstruction. The first step is to pull the clog out. This may seem simple and obvious, yet when many tubies are confronted with a clog, their instinct is to just push harder to get the offending item in.
This may just exacerbate the issue or lead to an explosive mess. The simplest solution is to take out your syringe, take a few deep breaths, push the plunger all the way into the syringe, reattach it to the feeding tube, and pull the plunger out to force the clog out the way it came.
Another way to clear clogs is to use warm water. Many tubies are firm believers in the idea that Coke, or other types of carbonated beverages, is the ideal way to remove a clog. In fact, there is no evidence that Coke is any more effective than water. While Coke has worked for some, it is just as likely that their clog would have been removed with time and water. Allowing the clog to soak in warm water gets it nice and wet and soft around the edges.
The best way to do it is to load the syringe up with water, attach it to the tube and gently push it until it meets the clog. Next, lightly push and pull on the syringe and see if the clog moves at all. Be patient with the clog. After gently pushing and pulling with warm water around the clog, it should come lose and you can push it the rest of the way into your stomach.
If the clog refuses to go in any further, but you can pull it out, make sure to draw it out completely into the syringe. Then you can clamp your tube, detach the syringe, and get rid of the clog. Patience is key here.
It could take 20 minutes to move the clog, but dealing with it at home is preferable to going to the ER. Just keep the warm water against the clog with a syringe and gently try pushing and pulling on it every few minutes. Eventually hopefully the clog will get mushy enough to move through the tube.
While Coke, or other carbonated drinks, have little or no effect on clogs, there are other liquids that may help break down the clog. Instead of warm water you can try meat tenderizer, papaya juice, mango juice, pineapple juice, or kiwi juice. There is also a product available online called Clog Zapper that is specifically made to unclog feeding tubes one of the main ingredients is also found in meat tenderizer and papaya juice.
All these will also take time about minutes to work but the enzymes in these products should soften most clogs enough for you to clear them. Be sure to immediately call your doctor for further instruction.
This article is designed for educational use only and does not replace the advice of a medical professional. For more information about securing a dislodged g-tube, or what to do when your g-tube has become dislodged, please contact your primary care physician. You can also find more information about g-tubes through the Oley Foundation and the Feeding Tube Awareness Foundation. Shield HealthCare Stronger with Shield. All Rights Reserved. Careers Careers at Shield.
Contact Contact Shield Locations Newsletter. Learn More. This is a shot of medicine in your skin to numb the area where the cut is made. You will be given medicines in an IV to help you relax.
These will make you sleepy. You may not feel pain or remember the procedure. You may feel pressure or pushing during the procedure. You can have a little pain after it is put in. You can take mild pain medicine to help with any pain.
Your medicines may need to stop or change before your PEG tube is put in. Call the doctor who ordered your medicines at least 2 weeks before your procedure. Give your care team a list of all your medicines and doses. Tell your care team if you use any herbs, food supplements, or over-the-counter medicine. Tell your care team if you are allergic to any medicines. We will ask you to sign a legal paper called a consent form. It will tell you about the procedure and the risks.
Signing the form gives your doctor permission to place your PEG tube. Make sure all of your questions are answered before you sign the form. You will stay in a recovery room until you are fully awake and ready to go home or to your hospital room. Clean the skin around your PEG tube every one to three days or if it is dirty with mild soap and water.
Try to gently remove any drainage or crusting on the skin or tube. Then put a new bandage around the tube. Yes, you can do normal activities after the skin around your PEG tube heals. Be sure it is closed before getting into a pool or tub.
Liquid, such as formula, fluids, and medicines, can be put through the PEG tube. Do not put pills into your PEG tube. A dietitian will talk with you about the commercial formulas that are best for you to get a balanced diet with all the vitamins and minerals you need.
They will talk to you about how much and how often to give yourself the formula. Use these formulas so your tube does not get blocked. You can give yourself feedings at any time during the day or night. Some people feed themselves at normal meal times.
Some people choose other times during the day or overnight. No matter when you decide to feed yourself, it still may be nice to sit with your family during meal times to share and talk.
Also, be sure you choose feeding times that let you get enough sleep. You can give yourself medicine that is liquid or finely crushed and dissolved in water. Never mix medicines. Always flush the tube with a little water between each medicine and after the last medicine is given.
0コメント