Patient education: Surgical gastrostomy – Discharge instructions (The Basics)

What are discharge instructions? — Discharge instructions are information about how to take care of yourself after getting medical care for a health problem.

What is gastrostomy? — Gastrostomy is surgery to put in a feeding tube. Feeding tubes are a way of getting the nutrients you need if you cannot get enough nutrition from eating or drinking by mouth.

For a gastrostomy, the doctor makes a cut (incision) in the stomach wall, and then puts in a feeding tube that goes into the stomach. This type of feeding tube is called a "gastrostomy tube," or "G tube" (figure 1).

G tubes are usually needed for people who will be unable to get enough nutrition from eating or drinking for 4 weeks or longer. Your doctor will talk to you about how long you will need the G tube before it is put in.

This surgery can be done in 2 ways:

●Open surgery – During open surgery, the doctor makes an incision in the skin. This lets them see directly inside the body when they do the surgery.

●Minimally invasive surgery – "Minimally invasive" surgery lets the doctor make smaller incisions in the skin. They insert long, thin tools through the incisions. One of the tools has a camera (called a "laparoscope") on the end, which sends pictures to a TV screen. The doctor can look at the screen to see inside the body. Then, they use the long tools to do the surgery. They can control the tools directly, or with the help of a robot (this is called "robot-assisted" surgery).

You might be able to return to normal activities sooner if you had minimally invasive surgery than if you had an open surgery.

How do I care for myself at home? — Ask the doctor or nurse what you should do when you go home. Make sure that you understand exactly what you need to do to care for yourself. Ask questions if there is anything you do not understand.

For the first 24 hours after surgery:

●Do not drive or operate heavy or dangerous machinery.

●Do not make any important decisions or sign any important papers.

●Do not drink alcohol of any kind.

You should also:

●Take care of your incision – You will have stitches on your incision.

•Keep your incision dry after surgery. Your doctor or nurse will tell you exactly how long you need to keep your incision dry.

•Once you no longer need to keep your incision dry, gently wash it with soap and water whenever you take a shower. Do not put your incision underwater, such as in a bath, pool, or lake. This can slow healing and raise your chance of getting an infection.

•After you wash your incision, pat it dry. Your doctor or nurse will tell you if you need to put an antibiotic ointment on it.

•Always wash your hands before and after you touch your incision or bandage.

●Make sure that you know how to take care of the G tube, once the area has healed. Your doctor or nurse will show you how to do this. In general:

•Keep the skin around the G tube clean and dry.

•Clean the outside of the tube with soap and water. You can use a cotton swab.

•Do not put creams or powders around the G tube unless your doctor or nurse tells you to.

•Do not put bandages between the G tube's bolster and your skin. (The bolster is the round piece on the outside of your body. It helps hold the G tube in place.)

•Your doctor or nurse will talk to you about how to flush the tube with water and how to feed yourself. Make sure that you understand their instructions. Ask questions about anything you do not understand.

●Take care of your mouth – Even if you don't eat or drink anything by mouth, it's still important to take care of your mouth and teeth. Brush 2 to 3 times a day, and floss regularly. You can also use mouthwash to freshen your mouth.

●Take all of your medicines as instructed.

●Increase your activity slowly – Your doctor or nurse will tell you exactly when you can do your usual daily activities again.

●Use a stool softener to help prevent constipation, if needed. This is a common problem if you take opioid pain medicines. Follow all instructions for taking your pain medicines.

What follow-up care do I need? — The doctor will want to see you again after surgery to check on your progress. Go to these appointments.

If you have stitches, you will need to have them taken out. Your doctor will let you know when your stitches should be removed. Some stitches absorb into the skin on their own and do not need to be removed.

You might need to work with a dietitian. They can help make sure that you are getting all of the calories and nutrition you need through the G tube. You might also work with a "home health agency" to help get the supplies and liquid food or formula.

When should I call the doctor? — Call your doctor or nurse for advice if:

●You have problems with the G tube, such as:

•The tube comes out.

•You cannot feed yourself through the tube.

•You cannot flush the tube with water.

•Your skin around the tube is swollen, red, or hurts to touch.

•You see yellow, green, or bloody discharge in or around the tube opening.

•There is a bad smell coming from the tube.

●You have a fever of 100.4°F (38°C) or higher, or chills.

●You have redness or swelling around the incisions from surgery.

●You have nausea or vomiting.

●You have hard stools or diarrhea, are not able to have a bowel movement, or are not able to pass gas.

●You have any symptoms that worry you.

More on this topic

Patient education: Surgical gastrostomy (The Basics)
Patient education: Enteral (tube) feeding (The Basics)
Patient education: How to give a tube feeding (The Basics)
Patient education: How to care for a G tube or G button (The Basics)
Patient education: How to care for a nasogastric tube (The Basics)