A gastrojejunal tube (G-J tube) goes through the skin of the belly, into the stomach, then into the jejunum, the second part of the small intestine. It can be dislodged (pulled out of place) and end up in the stomach or even outside the body. Children can dislodge a G-J tube by pulling on it, rolling over during sleep, or getting it caught on something. Your child's G-J tube has been replaced and has been checked by your health care provider. It is now safe to use it as usual.

Follow your health care provider's instructions for usual care of the G-J tube, including:

• how to bathe your child
• which physical activities are OK
• any prescription creams or ointments that are needed for the stoma or surrounding skin
• any medicines that your child needs to take
• when and how to flush or vent the tube
• how to clean the area around the tube
• how to secure the tube so it doesn't move around or fall out
• how to prepare and give feeds and medicines

Reminders:

• Always wash your hands before and after touching the G-J tube.
• Do not rotate (turn) the tube — this can cause it to twist or make the stoma get too big.
• Don't let your child pull on the tube. It may help to put mittens on your child's hands before bed to keep them from pulling on the tube while sleeping.
• Be aware that the feeding set tubing can get wrapped around a child's neck and lead to strangulation and death. Talk to your health care provider about how to keep the feeding set tubing away from your child as much as possible.

• The length of the tube outside the body has changed. Do not try to adjust the tube on your own.
• The G-J tube is clogged and you can't clear it with gentle flushing.
• The tubing splits or looks worn.
• Your child:
  • has a fever or signs of infection, such as redness, swelling, warmth, pus, or foul-smelling discharge near the stoma
  • gets a cough
  • has coughing or choking with feeds
  • develops diarrhea

• There is:
  • leakage of fluid on the skin around the stoma or a rash around the stoma
  • bleeding from the stoma
  • soft, moist, pink-red tissue (called granulation tissue) coming out from around the tube site

• The G-J tube comes out. Do not try to adjust the tube or put it back in.
• Your child:
  • has severe belly pain or a bloated or hard stomach
  • can't poop or pass gas
  • vomits
  • has trouble breathing

What can happen if the G-J tube is dislodged? If the tube is no longer correctly in the jejunum, your child may not get the nutrients and medicine they need. If it is completely out of the body, the stoma may start to close and make it hard to get the tube back in. So it's very important for a health care provider to replace it quickly.