Feeding Tube Insertion (Gastrostomy): Types, Risks, Procedure And Complications

Gastrostomy Feeding Tube Insertion (GFTI) is a process in which a feeding tube is placed inside the stomach of a person through the skin to help them get nutrition when they are unable to swallow by mouth. The process by which it is inserted is called endoscopy. GFTI is known by several names like PEG tube insertion, G-tube insertion or Percutaneous endoscopic gastrostomy tube insertion. ^[1]

The process of the insertion of the feeding tube is very flexible and does not require much time to perform. GFTI allows healthy fluids, nutrition and medicines to pass directly into the stomach without the pain of chewing the food. Once GFTI is done, the medical expert teaches the process to the patient and their relatives for everyday use.

Reasons For Inserting A Feeding Tube

The process of the insertion of the feeding tube is carried out due to the following reasons: ^[3]

• Difficulty during swallowing food
• Disorder of the oesophagus or mouth which makes eating challenging
• Unable to get enough nutrition orally
• Conditions like stroke, dementia or motor neuron disease.
• Decompressing the stomach due to bloating or abdominal distention
• Removing food content responsible for discomfort

Types Of Feeding Tubes

Feeding tubes are suggested based on the patient's health condition and the time limit for which they need it. Some of the types are as follows: ^[2]

• Jejunostomy Tube (J tube): It is among the long-term feeding tubes which is inserted into the small intestine by making a small cut in the abdominal area. It is smaller in shape and allows only thin liquids and powdered medicines to enter.
• Gastric Tube (G tube): This long term feeding tube is inserted from the mouth to the stomach followed by a small cut in the left upper side of the stomach. The tube helps to provide fluids and medications to the stomach.
• Percutaneous Endoscopic Gastrostomy (PEG): In this long-term feeding tube insertion process, the tube is placed in the stomach by a small cut which is made in the upper abdomen of the patient.
• Nasogastric (NG) Tube: It is a short-term feeding tube insertion in which a tube is inserted from the nose to the stomach. It is effective for 4-6 six weeks and later, replaced with a long-term one.

Risks Associated With Feeding Tube Insertion

Risks associated with the insertion of the feeding tube are as follows: ^[4]

• Before the surgical process, medications like blood thinners and anti-inflammatory drugs should be stopped as they may cause certain side effects during or after the surgery.
• Dosage of the daily medications for individuals with chronic disorders like diabetes, heart disorders and allergies should be adjusted to prevent drug interaction.
• Anaesthesia given during the surgery can make you feel drowsy even after the surgery.
• The surgery requires fasting for 8 hours which may cause nausea.

Procedure For The Insertion Of A Feeding Tube

Here is the step by step process for the insertion of a feeding tube. ^[5]

• Local anaesthesia or intravenous sedative is administered to the patient for a painless surgery experience.
• The medical expert then inserts the endoscope into the mouth first and then, move it inside the stomach with the help of the camera and light attached to it.
• When the stomach is seen, they make a small incision or opening in that stomach area by making a cut in the skin.
• Then the feeding tube is inserted into the stomach through the incision.
• The dressing of the incision is carried out around the stomach to avoid the leakage of food from the stomach.
• The process lasts less than an hour and the type of feeding tube depends on the condition of the patient.

What To Do After The Surgery

The incision in the stomach requires around 5-7 days to heal. A medical expert or a dietician help to educate the patient and their family members on the usage of the tube. Clean the surgical area with mild soap and water once in a day. Keep the skin dry to avoid irritation to a burning sensation.

Complication After The Surgery

• Pain in the surgical area
• Leakage of the content of the stomach
• Infection near the surgical area
• Bleeding
• Malfunction of the tube
• Perforation (unwanted hole) in the GI tract making its content fall in the abdominal area and causing an infection
• Intestinal obstruction or blockage
• Electrolyte imbalance in the body
• Diverticulitis

In severe cases, the patient may suffer from acute kidney injury, multiple trauma or acute respiratory disease syndrome.