Infants/
Children

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Gastro-Jejunostomy (GJ) Tube

Before the Procedure

On the day of the surgery, you should be shown a GJ tube or a picture of one, with an explanation of its capabilities, including when to use the jejunal and gastric ports. GJ tubes may be low-profile or standard-length.

You will be instructed 24-48 hours on pre-procedure protocol, including how to prepare for surgery, such as bathing your child, and a specific number of hours to hold fluids and foods.   You’ll also be given instructions on what supplies are needed and where to get them.

Your care team will review information on how to use your tube and supplies again after the procedure.

During the Procedure

Your child will receive general anesthesia for the procedure. Expect the procedure to take one hour, with one to three hours in the post-anesthesia recovery area.

For laparoscopic placement, the abdomen will feel full because air was placed into the abdomen to assist with the tube placement.

After the Procedure

Your child won’t be allowed to eat for a few hours to 24 hours after the procedure. The care team will watch your child closely. When the time’s right, they’ll start feeds using Pedialyte at first.

Your child won’t be allowed to bathe again until the next day after the surgery.  Specific instructions will be given on what to do, such as preventing the tube site  from being submerged in bath water for one to two weeks after the surgery.

Your care team will teach you how to clean the stoma site. It’s normal for there to be some drainage after the procedure that’s blood-tinged, clear, or cream-colored. Your care team may use a dressing to absorb the drainage. Dressings will be used only in the initial days of post op, if drainage occurs.  Be sure to change the dressing as often as needed to keep the site dry, as wet and soiled dressings can cause the skin to breakdown around the stoma site.  Some redness after the procedure is normal and should go away in about three days.

Your child may be given medication to help with pain, as well as a prescription to take home.

Your care team will teach you how to administer feeds, medication, venting, and what requires emergent (immediate) attention and care and what can be addressed within a 24 hour period. You’ll also be given a feeding schedule.

Remember: do NOT rotate this GJ tube. You’ll need to monitor your child for excessive touching of their new tube.

You’ll be told who and when to call if you have any problems.

Your First Day at Home

On your first day home, continue to watch for signs of pain and give medicine based on your care team’s advice.

Follow your feeding schedule and instructions, utilizing venting as needed and if recommended by your care team. Set up your pump for continuous feeds if needed.  You may use a pump on a pole or in a backpack if your child is mobile.

Make sure the tube is protected from excessive handling by your child, as well as protected from pets or siblings.

Give your information to your home medical equipment provider for future supply needs. You’ll also want to schedule a date for GJ tube replacement as well as a post-procedure clinic visit.

Practice daily tube and stoma care and remember to practice oral care, such as frequent toothbrushing or using infant swabs, regardless if any food or medication is taken orally.  Flushing your GJ tube is particularly important.  Be sure you understand best practices and frequency of flushing to help prevent your tube from becoming clogged.

If you run into any questions, don’t be afraid to reach out to your care team.

Remember: the first day at home after any big change is going to require some adjustment. But before long, you’ll become more used to the feeding tube and you’ll develop a new routine that’s second nature to you.

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