Gastrostomy

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A gastrostomy tube in place.

A gastrostomy is a surgical procedure for inserting a tube through the abdomen into the stomach. It is used for feeding patients who cannot swallow food. This procedure is often performed when a patient has difficulty with oral intake due to conditions such as neurological disorders, cancer, or gastrointestinal diseases.

Indications

Gastrostomy is indicated in patients who require long-term enteral nutrition. Common indications include:

• Neurological disorders such as stroke, cerebral palsy, or motor neuron disease.
• Head and neck cancer that obstructs the normal swallowing mechanism.
• Severe anorexia or malnutrition where oral intake is insufficient.
• Gastrointestinal disorders that impair normal digestion and absorption.

Procedure

The procedure can be performed using different techniques, including:

• Percutaneous Endoscopic Gastrostomy (PEG): This is the most common method, where an endoscope is used to guide the placement of the tube.
• Surgical Gastrostomy: This involves a direct surgical approach to place the tube, often used when endoscopic methods are not feasible.
• Radiologically Inserted Gastrostomy (RIG): This method uses imaging guidance to place the tube.

Complications

While generally safe, gastrostomy can have complications such as:

• Infection at the insertion site.
• Bleeding or perforation of the stomach or abdominal wall.
• Tube dislodgement or blockage.
• Aspiration pneumonia if gastric contents are regurgitated.

Care and Maintenance

Proper care and maintenance of the gastrostomy tube are essential to prevent complications. This includes:

• Regular cleaning of the tube and surrounding skin.
• Flushing the tube with water to prevent blockages.
• Monitoring for signs of infection or irritation.

Related pages

• Enteral nutrition
• Percutaneous endoscopic gastrostomy
• Feeding tube
• Parenteral nutrition