Is a gastrostomy (G-tube) used for draining peritoneal fluid, urine, feeding purposes, or weight loss?

Gastrostomy Tube Purpose and Function

A gastrostomy tube (G-tube) is primarily used for feeding purposes when patients cannot meet their nutritional needs orally for extended periods. 1, 2

Primary Indications for Gastrostomy Tube Placement

• Enteral Feeding

  • For patients with enteral feeding needs likely to exceed 4-6 weeks 2
  • For patients at high risk of malnutrition who are unlikely to recover oral feeding ability in the short term 2
  • For patients with neurological disorders affecting swallowing, cognitive impairment, or mechanical obstruction to swallowing 2, 3

• Gastric Decompression

  • Used for relief of gastric outlet obstruction in advanced gastric cancer 1
  • For decompression in cases of enteral obstruction 1
  • For venting purposes when obstruction cannot be alleviated or bypassed 1

Types of Gastrostomy Tubes Based on Function

1. Feeding Gastrostomy Tubes

   • Most common purpose - providing nutritional support 1, 2, 3
   • Placed directly into the stomach through the abdominal wall 3
   • Preferred over parenteral nutrition when the GI tract is functional 3

2. Venting Gastrostomy

   • Created to decompress the upper GI tract for symptomatic relief 1
   • Used in patients with distal obstruction or severe dysmotility 1
   • Can allow for some oral intake of liquids and soft foods despite obstruction 4

3. Gastrojejunostomy Tubes

   • Dual-purpose tubes that provide both gastric decompression and feeding 3
   • Access to the jejunum is created through the stomach 1

Placement Methods

• Endoscopic placement (PEG) - performed at bedside, no radiation exposure 2
• Radiological placement - suitable for patients with upper GI tract narrowing 2
• Surgical placement - may be done during other abdominal procedures 2

Contraindications for Gastrostomy Placement

• Gastroesophageal reflux
• Previous gastric surgery
• Ascites
• Extensive gastric ulceration
• Neoplastic/infiltrative disease of the stomach
• Gastric outlet obstruction
• Coagulopathy
• Hepatomegaly
• Gastric varices 2

Complications

• Major complications include aspiration (0.3-1.0%), hemorrhage (0-2.5%), peritonitis (0.5-1.3%), and death (0-2.1%) 1
• Minor complications include ileus (1-2%), peristomal infection (5.4-30%), stomal leakage (1-2%), buried bumper (0.3-2.4%), gastric ulcer (0.3-1.2%), fistulous tracts (0.3-6.7%), and inadvertent removal (1.6-4.4%) 1
• Tube dysfunction such as clogging or deterioration can occur at any time 3

Important Considerations for G-tube Use

• Prophylactic antibiotics should be administered 30 minutes before insertion 2
• Tubes should not be removed for at least 14 days after insertion to ensure tract formation 2
• Regular flushing with sterile water is recommended to prevent clogging 1
• The external bumper should be placed approximately 1cm or more from the abdominal wall 2

G-tubes are not used for draining peritoneal fluid or urine, which would require different types of drainage catheters. While some bariatric procedures may involve temporary gastrostomy placement, G-tubes are not primarily used as a weight loss measure 1.