What Does GT Stand For?
GT stands for Gastrostomy Tube, which is an artificial access into the stomach created through a small incision in the abdominal wall to provide feeding, medication administration, and/or decompression. 1
Definition and Purpose
A gastrostomy tube is a flexible synthetic tube that provides direct access to the stomach through the abdominal wall, bypassing the oral and esophageal routes. 1 The primary functions include:
- Nutritional support for patients unable to maintain adequate oral intake 1
- Medication administration when oral routes are not feasible 2
- Gastric decompression in patients with obstruction or severe dysmotility 1
Types of Gastrostomy Tubes
By Placement Method
- Percutaneous Endoscopic Gastrostomy (PEG): Placed using endoscopic visualization, typically via a transoral approach where the tube is pulled through the mouth and stomach wall 1
- Percutaneous Image-Guided Gastrostomy (PIG): Placed using fluoroscopy, ultrasound, or CT guidance through a transabdominal approach 1
- Surgical gastrostomy: Placed during open or laparoscopic surgery 1, 3
By Retention Mechanism
- Balloon-type tubes: Use an inflatable balloon to secure the tube internally 1
- Bumper-type tubes: Use a rigid or distensible internal bumper for retention 1
- Low-profile tubes: Skin-level devices that are more cosmetically acceptable 1
Clinical Indications
Gastrostomy tubes are indicated when enteral feeding is expected to be needed for more than 4-6 weeks, though some evidence suggests placement as early as 14 days post-acute dysphagic stroke. 1 Common indications include:
- Neurological disorders: Stroke, multiple sclerosis, motor neurone disease, Parkinson's disease, cerebral palsy 1
- Mechanical obstruction: Oropharyngeal or esophageal cancer, radiation enteropathy 1
- Cognitive impairment: Head injury with depressed consciousness 1
- Chronic intestinal dysfunction: Short bowel syndrome, fistulae, cystic fibrosis requiring supplementary intake 1
Important Distinction: GT vs GJ Tube
A gastrojejunostomy (GJ) tube is different from a standard GT—it creates access to the jejunum through the stomach, typically with two ports allowing simultaneous jejunal feeding and gastric decompression. 4 This is particularly useful for patients requiring both functions concurrently. 1, 4
Common Pitfalls
- Inappropriate patient selection: The overall mortality within weeks of PEG placement can be very high, usually due to the underlying condition rather than the procedure itself, making careful patient selection critical. 1
- Ethical considerations: The invasive nature of GT placement requires thorough discussion with patients and families about goals of care before proceeding. 1
- Timing errors: Placing a GT too early (before 4-6 weeks) when patients might recover swallowing function, or too late when malnutrition has already become severe. 1