What is a low-profile balloon J tube?

This tube goes through the stomach and into the small intestine (jejunum). It is called a "low profile" tube because it lies close to the belly and does not "hang out". A balloon filled with water is inside the stomach to hold the tube in place.

Why does this tube have a valve on top and on the side?

One valve is for the intestine (jejunal port), and one is for the balloon.

How do these valves work?

These valves are one-way valves that act like trap doors. When the valve is closed, nothing can pass through that part of the tube. To open the valve to give feedings, medications, or to "vent" the stomach, a special tube called an extension is needed. The extension set locking adapter "locks" into either valve.

How does the secure-Lok extension set work?

• Match up the line on the extension set tubing with the line on the tube.
• Turn ¼ to ½ in the direction of the arrow. This opens the anti-reflux valve.
• When you are finished using the tube, remove the extension by turning it counterclockwise (in the opposite direction of the arrow) back to the line, remove it and close the cap.

Do I need a new extension set every time I access the tube?

No, you can wash the extension set in warm, unscented soapy water after each use. Rinse it well and hang it to dry.

Ask your home care company how many sets you will receive each month. This determines how often you can change them.

Why do these tubes need to be changed in Interventional Radiology?

G-J tubes and J tubes are replaced using X-ray guidance to make sure they are positioned correctly.

How often do the tubes need to be changed?

We recommend that tubes be routinely changed every three months.

What are the risks associated with tube changes?

• Loss of access
• Bleeding at the stoma
• Infection at the stoma
• Bowel perforation. This is very rare.

What kind of skin care do I need to provide for my child's tube site?

You should look at the stoma site and surrounding skin once a day. A little drainage and redness at the opening is normal. Clean the stoma daily with unscented soap and dry the area well. Do not scrub the area because that can cause the skin to break down. Instead, wipe it gently.

Please call your doctor or nurse practitioner if you see any of the following:

• A rash with red dots on the edges
• Increased redness or swelling around the stoma
• Open areas of skin around the stoma
• Bleeding from the stoma site
• Bleeding, painful or growing (granulation) tissue around the stoma
• Increased leakage at the stoma site
• Vomiting of formula when on "J" feeds

What do I do if the tube clogs?

The intestinal portion of the tube can clog easily and therefore needs to be flushed with water throughout the day and after all feedings and medications administration. The stomach (gastric) portion should be flushed once a day.

If the tube becomes clogged, attach a 5ml syringe of warm water to the feeding tube adapter. Try flushing the tube. If you are unable to flush, pull back on the syringe plunger. Try to flush and pull back up to 5 times. If you are still unsuccessful, try using a 3ml syringe of warm water and repeat the above steps.

If after attempting the above you are still unsuccessful, please call 215-590-7000 and press prompt #1 and then prompt #2 to schedule the tube for replacement. (Mondays through Fridays 7 a.m. – 5 p.m.). After 5 p.m. during the week, call the above number first thing the next morning.

On the weekends and holidays during the day call 215-590-1000 to reach the hospital operator and ask for the Interventional Radiologist on call.

If your child cannot go without fluids, has a metabolic disease, or cannot skip a dose of medication (please check with your healthcare provider which medications cannot be skipped) then go to the CHOP emergency department until a replacement tube can be arranged.

What do I do if the tube falls out?

In general, the loss of a GJ tube is not an emergency. If the tube falls out, place the end of the old tube into the stoma 2 inches and tape it into place. This will keep the stoma from closing. DO NOT FEED through the tube.

Please call 215-590-7000 and press prompt #1 and then prompt #2 to schedule the tube for replacement. (Mondays through Fridays 7 a.m. – 5 p.m.). After 5 p.m. during the week, call this number first thing the next morning.

On the weekends and holidays during the day, call 215-590-1000 to reach the hospital operator and ask for the Interventional Radiologist on call.

If your child cannot go without fluids, has a metabolic disease, or cannot skip a dose of medication (please check with your healthcare provider which medications cannot be skipped) then go to the CHOP emergency room until a replacement GJ tube can be arranged.