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Skin problems with a feeding tube

 

Leaking and skin irritation

Moisture from the stomach can build up on the skin around your child’s stoma. This can make the skin red and irritated. If you notice any redness, clean your child’s skin with water several times each day.

Change the dressings when they start to look dirty. If these steps do not help, tell the clinical nurse specialist or another member of your St. Jude team. They can give you creams and dressings that can help.

Dressings

The following is a list of reasons a feeding tube might leak:

  • A deflated or leaky balloon. Read “Do You Know… Troubleshooting Feeding Tube Problems” to learn more.
  • A stoma that has stretched. If the stoma has gotten larger, the tube might be moving back and forth. This can stretch the stoma more and cause a leak around it. Be sure you attach the tube firmly to your child’s skin with a dressing. Talk to your child’s clinical nurse specialist or St. Jude team about the problem. Your child might need a different sized tube.
  • A stomach that is too full or contains air. Read “Do You Know… Feedings, Venting, and Reflux.”
  • A tube that leaks during bolus feedings. Try to slow down the rate of feeding or switch to continuous feedings. Talk to your child’s dietitian or other member of the St. Jude team for suggestions.

Your child’s doctor might prescribe medicines to reduce your child’s stomach acid and help with stomach emptying. If your child still has problems, talk to your St. Jude team.

Granulation tissue

Granulation tissue
Granulation tissue
Silver nitrate

Granulation tissue is extra tissue that grows at the stoma site. It might look red and spongy, and it can bleed easily. Granulation tissue can grow when:

  • Bacteria are present,
  • The tube does not fit the stoma correctly, or
  • There is too much moisture around the tube.

If you notice granulation tissue, call your child’s clinical nurse
specialist or another member of the St. Jude team. The tissue can be removed if needed.

Here are some ways to keep granulation tissue from building up:

  • Make sure the feeding tube is stable (not moving around).
  • Put on a thick foam dressing and tape. This can sometimes stop the growth. There are different types of foam dressings, including some that fight infection. Talk to a St. Jude wound care nurse or the clinical nurse specialist about this.

If the granulation tissue needs to be removed, a chemical called silver nitrate will be used or it may require surgery.

The right treatment depends on how much the tissue has grown. Granulation tissue might come back even after several treatments.

Infection

Infection

Infection in the stoma or skin around it is rare. Redness and irritation from leaks might look like infection, especially when stomach contents get mixed with bacteria on the skin. If this happens, you might notice a colored discharge that smells bad. You can see and smell this fluid on your child’s skin, dressings, and clothes. Changing your child’s dressings and cleaning the skin more often usually gets rid of redness caused by leaks.

Call your St. Jude team if:

  • Your child’s skin gets redder even though you don’t see fluid leaking out,
  • The stoma is sore and red,
  • You notice pus or a bad smell, or
  • Your child has a fever.

Bleeding

Several things can cause bleeding around the stoma. For example, you might notice a small amount of blood during a tube change. A little bleeding is not serious. If you see a lot of blood, put pressure to the area of bleeding and call St. Jude right away.

The stoma might also bleed a little if the tube moves too much and irritates the area. Keeping the tube stable and in the correct position should stop the bleeding. Call the St. Jude team if the bleeding does not stop in a few minutes or gets worse.

Granulation tissue can also bleed. Call the St. Jude team if you notice red, spongy tissue growing around the stoma.

Neutropenia

Neutropenia and the feeding tube

Neutropenia means that certain white blood cells, called neutrophils, are at a very low level. When your child’s neutrophil count drops to less than 500, the skin around the stoma can get red and irritated. This is not a long-lasting condition. It will get better as the neutropenia gets better.

During this time, you can protect the stoma and skin with creams and dressings. Ask your St. Jude wound care nurse or clinical nurse specialist about the best options for your child.

Questions?

If you have questions or your child has one of the problems and the suggestions do not work, please call your St. Jude team for help. The clinical nurse specialist and other members of your St. Jude team are always here to help you and your child.


 

This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health concerns or specific treatment options should be discussed with your physician.

St. Jude complies with health care-related federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

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