Introduction

The G- tube and Monarch® gastrostomy tube are specially designed silicone feeding tubes that are inserted into the stomach through the abdominal wall. This allows liquid feed, water, or medication to be delivered directly into the stomach.

The G- tube is secured in place by an internal inflatable balloon at one end and an external fixator at the other. The child/young person would be measured and fitted for the appropriate size of tube by a healthcare professional.

The Monarch® gastrostomy tube is secured with an internal silicone retention disc at one end and an external fixator at the other.

Your child may have a G-Tube or Monarch® gastrostomy tube placed as their first gastrostomy tube, or they may have had a PEG tube that is then changed to a G-Tube or Monarch® gastrostomy tube. If it is placed as their first gastrostomy tube it may have stitches. Your community nurse will remove these 5-7 days after the gastrostomy tube is inserted.

Serious complications related to gastrostomy tubes are rare and symptoms are usually seen within 72 hours after insertion or tube change.

Symptoms to look out for between 3-5 days of insertion or change include:

• Pain or distress on feeding
• Fresh bleeding from the gastrostomy tract
• Leakage of feed around the tube.

If any of these occur, you should call for advice (Please refer to Contact Points for details).

There are several reasons:

• They may not be able to feed by mouth.
• They may be unable to take enough food by him/herself to grow adequately.
• They may require overnight gastrostomy feeds to help gain weight or because of certain medical conditions.

These are administered in two ways:

• By gravity (this is known as bolus feeding) ~ A measured amount of feed is given slowly by a syringe over 15-20 minutes.
• By pump ~ This may be administered at set times during the day and night or used only overnight. Pumps are designed to allow a steady flow of the feed.

The child/young person’s dietitian assesses their overall nutritional needs and make recommendations about specific amounts to be fed over a 24-hour period. This is dependent on the child/young person’s weight, height, and age. There are many different preparations of milk feeds and again the dietitian will recommend a specific type suitable for the child/young person. All children/young people will have a feeding care plan completed by a healthcare professional. Other preparations can also be given via this method i.e., water or medication.

G Tube

The life span of the gastrostomy tube depends on several factors:

• types of medications/ feeds used.
• volume of water used to inflate the balloon.
• the acidity of the gastric fluid.
• tube care.

A healthcare professional will advise on the length of time the tube can remain in place. You should ensure that you always have a spare gastrostomy tube available for your child.

Monarch®

The life span of the gastrostomy tube depends on several factors:

• types of medications/ feeds used.
• the acidity of the gastric fluid.
• tube care.

A healthcare professional will advise on the length of time the tube can remain in place. Your child will need to have an operation to change the gastrostomy tube.