Issues Abut Tubes & Ostomy

Information Sheet for Patents – Gastrostomy Buttons

Pull Through Rash Ointments

Information Sheet for Parents – Gastrostomy Buttons

If your child has a gastrostomy tube, one of our goals is to help you become self-sufficient in your child’s care. One of our doctors or nurses will ask you if you would like to learn how to place the button appliance yourself. If you can learn to do this, you will not need to bring your child to the Emergency Department, the clinic or the doctor’s office to have the tube replaced if it malfunctions.

The button gastrostomy kit is self-contained and has almost everything you need, including an instruction book. Sometimes, you will need to purchase some KY-jelly to help insert the tip of the tube into the stomach opening. Remember to use water (tap water, distilled water or sterile water are all okay) rather than salt water (normal saline) to fill the balloon. The salt from salt water can crystallize in the balloon, making it impossible to deflate the balloon and the tube cannot be easily removed from the opening.

If you are going to replace the tube yourself, it is best to have everything ready to go before you start the procedure. It is also nice to have an assistant, although it can be done by yourself.

THIS IS THE WAY YOU REPLACE THE TUBE:

Use an empty syringe to hook into the side port of the old tube to remove the water. Throw the old water away. Remove the old tube from the opening. Lubricate the tip of the new tube with KY-jelly, and put the new tube into the opening. The shaft of the tube must go into the opening completely, so that only the top of the tube is flush with the skin. Fill the balloon with the amount of the water that your doctor recommended. For infants, 3 cc of water is usually enough, and for older children 5 cc of water is best.

The tube should not be too loose or too tight. You should be able to twirl the tube around at the skin level, so that it does not cause pressure on the skin. If the shaft is too long, the formula may leak around the sides of the tube after you fill the stomach.

Most gastrostomy buttons will last at least six weeks, if not longer. Some children will not require a tube change for several months. If the child makes a lot of stomach acid, it may discolor the balloon and the balloon will look brown or black when you pull it out of the stomach. The acid tends to wear out the balloon a little quicker. One way that you can tell if the balloon is getting worn out, is to check the amount of water in the balloon once a week. If the water is less than what you put in, you should add enough water to make it 3 cc or 5 cc again. If you notice that the amount of water you need to add is increasing every week, it may be time to change the tube. Your tube also contains a one-way valve, and formula should never come back through the central opening in the tube when the extension tubing is not hooked to it. If you remove the extension tubing and notice a lot of formula leaking back through the center of the tub, the valve is broken and it is time to replace the tube.

If your child had an anti-reflux procedure, he or she may gag or retch when the stomach is too full. Sometimes you can relieve the pressure by connecting the extension tubing to the button, and opening it to release the air.

There are several medical supply companies that can assist you with acquiring your gastrostomy tubes. Some of them are listed below. If you have home health, the home health company may be affiliated with a medical supply company that can get the tubes for you. WE DO NOT SELL OR KEEP GASTROSTOMY TUBES IN OUR OFFICE. Therefore, our usual procedure is to supply you with a prescription and let you develop your own relationship with a company that can provide you with tubes when you need them.

If you have specific questions about the gastrostomy button, or if you feel that the tube is too small or too long, you should call our office at (502) 583-7337 and we will do our best to help you. If your child gains a lot of weight, it may be that we need to see him or her and remeasure for a better sized button.

Pull Through Rash Ointments

Ilex Skin Protectant Paste – Protective barrier paste used for ostomy care and incontinence.

  1. 1.800.443.6332 or www.medconbiolab.com
  2. 1.800.228.7150 Shield Healthcare, Valencia, CA.

Critic Aid Skin Paste – Protective barrier paste used for ostomy care and incontinence.

Carrington Gel – A wound healer applied after diaper changes.

Aquafor Cream – Used on raw skin, stays on for a while; eucerite ointment base.

Eucerin – Moisturizing cream used to keep skin soft.

Balnol – Wipe down with cosmetic cotton squares.  Gets the skin clean, no need to rinse.

Silvadene – Apply to rash (burn cream).

Questrin powder – Mixed with Aquafor then apply to rash.

Baby Oil and Tissues – Use to clean bottom.

Uni-Solve – Provides a water-repellent shield against external fluids.  Helps retain natural skin moisture.  Use to prevent skin breakdown due to dryness, friction, pressures and incontinence.

Gynelotrimin – Vaginal infection medications can sometime work on yeast type rashes.

Aloe – Apply fresh aloe to rash area.  Let dry well then apply Desitin Diaper Rash Ointment and A & D Ointment on top of dried aloe.

Aveeno Bath – Leave diaper off, apply baking soda to bottom to remove sting.

Aloe Shampoo – Spray on washcloth, apply to rash area, let dry.

Nurse’s Remedy –

  1. Mix the following together. Zinc oxide, A & D ointment, Nystatin cream, Tincture of Benzoine (5 drops) and Stomahesive powder to make a smooth Consistency and apply after each diaper rash
  2. Mix the following in equal parts.  Zinc oxide, A & D ointment, Nystatin Cream, Tincture of Benzoine (5 drops) and thick part of Maalox.

All Purpose white flour, brown in cast iron skillet (no oil or butter) until mixture clumps together.  Sprinkle in diaper.  Flour will absorb waste products.