How to use the G button? A guide to gastrostomy tube care

Proper management of gastrostomy tubes can significantly improve patient outcomes and reduce complications. Learning how to use the G button correctly is a crucial part of this care, helping patients and caregivers feel confident in their home care routine.

Quick Summary

Using a gastrostomy (G-button) involves preparing and administering liquid nutrition or medicine via extension tubing, regularly cleaning the stoma site, and venting the device to release air from the stomach.

Key Points

• Identify Your Context: The 'G button' can refer to a medical gastrostomy tube, a programmable gaming key, or a camera menu button; in a health context, it means the medical device.

• Maintain Site Hygiene: Regular, gentle cleaning of the skin around the G-button is crucial to prevent infection and irritation.

• Master Feeding Techniques: Whether administering a bolus feed via gravity or a continuous feed with a pump, follow specific steps for safe delivery and proper flow control.

• Handle Medications Safely: Always check with a pharmacist before crushing pills and flush the tube with water before and after administering each medication to avoid clogs.

• Vent to Relieve Gas: Use an extension set to release trapped gas from the stomach, which can help alleviate bloating and discomfort.

• Know When to Call for Help: Monitor for signs of infection, persistent pain, or if the button becomes dislodged and seek medical attention if concerns arise.

Understanding the Gastrostomy (G-button)

A gastrostomy button, also known by brands like Mic-Key, is a low-profile feeding tube inserted directly into the stomach through the abdominal wall. It is used when an individual cannot safely or adequately receive nutrition, fluids, or medication orally. The G-button is held in place by an internal balloon and has a port on the outside for attaching extension sets, making it a less visible and more comfortable option than traditional G-tubes.

Preparing for G-Button Use

Proper preparation is essential to prevent infection and ensure a smooth process. Always follow these steps before handling your G-button:

1. Wash your hands: Thoroughly wash your hands with soap and water for at least 20 seconds.
2. Gather supplies: Organize all necessary items, including the prescribed formula or medication, a syringe, the extension set, and warm water for flushing.
3. Prepare the formula or medication: Ensure liquids are at room temperature. For medications, follow your healthcare provider's instructions regarding crushing pills or mixing. Never mix medications with formula unless specifically instructed to do so.
4. Clean the site: Before connecting, gently clean the stoma site around the button with a clean cotton swab and water to remove any drainage.

Bolus Feeding with a G-Button

Bolus feeding involves delivering a larger volume of formula over a shorter period, typically 10 to 20 minutes.

1. Connect the extension set: Open the cap on the G-button and align the markings on the extension set with those on the button. Insert the extension set and turn it clockwise about a quarter to three-quarters of a turn to lock it securely.
2. Attach the syringe: Remove the plunger from a catheter syringe and insert the tip into the open end of the extension set.
3. Fill and start the feed: Pour the formula into the syringe. Raise the syringe to increase the flow rate and lower it to slow it down, using gravity to control the speed. Keep the syringe filled to prevent air from entering the stomach.
4. Flush the tube: After the feeding is complete, flush the extension set with a prescribed amount of lukewarm water to clear it. This prevents clogging.
5. Disconnect: Clamp the extension set before disconnecting it from the G-button. Close the cap on the button once finished.

Continuous Feeding with a G-Button

Continuous feeding involves a slow, steady delivery of formula over a longer period, such as 8 to 24 hours, often using a pump.

1. Prepare the feeding bag: Close the clamp on the feeding bag tubing and fill the bag with the prescribed amount of formula. Unclamp briefly to prime the tubing, ensuring all air is expelled.
2. Connect to the G-button: Attach the feeding bag's connector to the G-button's feeding port.
3. Program the pump: Set the pump to the correct rate as directed by your healthcare provider. Unclamp all tubing and start the pump.
4. Flush the line: When the feeding is done, flush the tubing with lukewarm water until clear. Disconnect the feeding bag and replace the G-button's cap.

Administering Medications Through the G-Button

Medication administration requires careful attention to detail.

• Liquid medications: Draw up the exact dose into a syringe.
• Pills: Consult your doctor or pharmacist before crushing any pills, as some should not be crushed. Crush the pill into a fine powder and mix with a small amount of water to dissolve completely before drawing into a syringe.
• Follow instructions: Stop any continuous feeds. Flush the G-button with a small amount of water before and after administering medication. Use a separate syringe for each medication and flush with water in between.

Venting the G-Button to Relieve Gas

Gas can build up in the stomach, causing bloating, discomfort, or abdominal distention. Venting the G-button can provide relief.

Venting procedure

1. Attach a clean, empty extension set to the G-button.
2. Open the clamp on the extension set to allow gas to escape.
3. You may hear a hissing sound as the air is released.
4. Once the gas has been released, clamp the extension set and remove it from the button.

G-Button Site Care

Maintaining the site is critical to prevent skin irritation and infection.

• Daily cleaning: Use a clean cotton swab and water to gently clean around the G-button site twice a day. Start close to the site and work outwards.
• Check for redness: Inspect the skin for any increased redness, drainage, or signs of granulation tissue (red, beefy tissue). Report any concerns to your healthcare provider.
• Keep it dry: If there is minimal drainage, place a split gauze pad under the G-button to absorb moisture and keep the area dry.
• Secure the button: Use a G-button belt or other protective measures to prevent accidental pulling or excessive movement, which can cause irritation.

Comparison: Bolus vs. Continuous Feeding

Feature	Bolus Feeding	Continuous Feeding
Delivery Speed	Shorter duration (10-20 min)	Longer duration (8-24 hours)
Equipment	Syringe and extension set	Feeding bag, pump, and extension set
Flow Control	Controlled by gravity (raising/lowering syringe)	Controlled by an electronic pump
Mimics Meal Pattern	More closely mimics traditional meals	Provides a steady, uninterrupted flow
Ideal For	Individuals who can tolerate larger volumes and prefer flexibility	Individuals with compromised digestion or a need for slower, more controlled feeds

When to Seek Medical Attention

It is important to know when to contact your doctor or medical team. Seek help if you experience:

• Signs of infection at the stoma site (increased redness, swelling, or pus).
• Persistent abdominal pain, cramping, gagging, or vomiting.
• Leaking from the stoma site that does not stop.
• Difficulty inserting the extension set or flushing the button.
• The G-button falls out or becomes displaced.

Conclusion

Caring for a gastrostomy button requires attention to detail, proper technique, and adherence to your healthcare team's instructions. By understanding how to use the G button for feeding, medication, and venting, and by maintaining proper site hygiene, you can ensure safe and effective home care. Following these guidelines and staying in close communication with your provider will lead to better health outcomes and greater confidence in managing this medical device.

For more information on patient safety and care, visit the American College of Surgeons website.

Frequently Asked Questions

What is the G-button used for?

A G-button, or gastrostomy button, is a medical device used to deliver nutrition, fluids, and medication directly into the stomach. It is an alternative for individuals who have difficulty swallowing or require long-term nutritional support.

What supplies are needed for G-button care?

Essential supplies include the prescribed liquid formula or medication, an extension set, a syringe, warm water for flushing, cotton swabs, and split gauze to keep the site dry.

How do you administer medication using the G-button?

To administer medication, first stop any current feeding. Flush the tube with water, then administer the medicine using a syringe. Flush with water again after the medicine to clear the tube. Always use a separate syringe and flush between different medications.

How often should I clean the G-button site?

The G-button site should be cleaned gently with water and a cotton swab twice a day, or as directed by your healthcare provider, to remove any drainage and prevent infection.

How do I vent the G-button to release gas?

To vent the button, connect a clean, empty extension set to the button and open the clamp. This will allow built-up air from the stomach to escape. Clamp the set and disconnect when the venting is complete.

What should I do if the G-button falls out?

If the G-button falls out, contact your healthcare provider immediately. It is important to insert a replacement tube quickly to prevent the stoma from closing. You should have a replacement button and instructions on hand for such an emergency.

Is it normal for a G-button site to have some drainage?

A small amount of drainage can be normal, and a split gauze pad can be used to keep the area dry. However, increased or persistent drainage, especially if accompanied by redness or swelling, should be reported to your healthcare provider.