Once the tract or tunnel through the skin and abdominal wall directly to the stomach is well established it is quite easy to place a new tube directly into the stomach through the tract or tunnel. It is not uncommon that either the tube comes out or wears out over time or the patient, especially pediatric aged patients and very active adults request that the feeding tube be changed to a "low profile", that is nearly flush with the skin of abdomen. Such a low profile feeding tube is more easily to cover under clothing. When the originally placed tube comes out, becomes worn and a new tube needs to be placed the patient may prefer to change to a low profile tube. Replacement tubes with the mushroom like tips are stretched with a small stylus or pen-like probe to flatten them out to allow them to slip down the tract into the stomach where when reaching the stomach the pop back open to anchor the tube within the stomach. They are removed similarly to what I described in the last post, by firm tug with one hand and counter pressure down on the abdomen.

Another type of replacement tube has a balloon that is inflated with water after the tip is in the stomach then the water filled balloon is pulled up snug against the inside wall of the stomach and an external bolster is slid down over the tube outside the body to keep the tube in place. To remove the balloon is deflated by removing the water with a syringe. The main problem with this type of replacement tube is that the balloon can leak over time and deflate enough that the tube falls out. But is an easy replacement tube to place and a good choice when you want to maintain the tract pending placement of the more durable mushroom type tubes.

With any of the PEG feeding tubes, the tip is attached to a Y-connector adapter. It is attached to cut end of the tube to allow syringes to be connected to flush water, medications through the tube. If the tube gets clogged from food residue or medicines, an easy way to unclog is to squirt a syringe full of cola through the tube. Says something about the power cola to dissolve stuff doesn't it?

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PEG Feeding Tubes.

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