Dr. Kovacev's Feeding Tube Care
- 104 Circle Way Suite A - Lake Jackson, TX, 77566, Phone (979) 721-7007, Fax (979) 721-4254 -
What is a feeding tube?
Feeding tubes are tubes used to feed the intestinal tract for many reasons
Feeding tubes come in many different types, the most common are PEG ( Percutanous Endoscopic Gastrostomy), Gastrostomy, or Jejunostomy Tubes
PEG Tubes are feeding tubes placed in the stomach using endoscopy - a flexible camera passed into your mouth.
Gastrostomy Tubes are tubes placed in the stomach by a surgical procedure such as laparoscopy or open surgery
Jejunostomy are tubes placed into the small intestines past the stomach either by laparoscopy or open surgery
Supplies to purchase before surgery:
60 cc piston slip tip syringe
non-sterile gauze (4x4)
Hydrogen Peroxide, Antibacterial Soap, Sterile Cotton Q-Tips
10 cc Leur lock syringe
Case of
or other Protein Supplement Supplement - this will be temporary
until your medical grade tube feeding arrives to your home.
Pre-Surgical Preparation:
Review your medications PRIOR to surgery with your primary care doctor or prescribing doctor to ensure the medication can be given in a CRUSHED form through the feeding tube.
Do not eat or drink anything 12 or more hours prior to surgery
See your primary care doctor to see if any medical optimization / preparation is necessary prior to surgery.
Discuss blood thinners with your Cardiologist / Medical Doctor and review with Dr. Kovacev.
Tube Care:
Begin with water / electrolyte solution such as gatorade on evening of tube placement and begin regular tube feeding after 48 hours, as instructed.
You may shower 48 hours after tube placement.
To remove drainage, crusts, or blood from the skin around the tube, use a solution of half hydrogen peroxide-half water. Use Q-Tips once a day and as needed, followed by antibacterial soap and water.
Some drainage around the site is normal. It is important to keep your skin around the tube clean and dry.
Remove dressing 48 hours after surgery.
Your tube should be level with your skin.
Contact your physician immediately or go to the emergency room if your tube falls out.
PEG / Gastrostomy Tube Feedings ( NOT for Jejunostomy Tubes)
Sit upright or at least 45 degree angle during feeding and for 1 hour following the end of the feeding.
Flush tube with 60 cc warm water before and after each feeding to keep the tube clean and prevent build-up of medication or tube feedings in tubes which can cause a blockage.
Do not mix medications with feeding formula.
Medications should be given in liquid form if available. If pills are approved to be given through your feeding tube, you may crush finely with either a mortar and pestle or crused between spoons. Mix the powder in water until there are no clumps.
Give each medication separately. Flush tube with 10 cc of warm water between medications.
When you receive your prescription tube feedings, you will get instructions and they will be given to your home health nurse as well, if applicable
Jejunostomy Feeding Tubes:
Sit upright or at least 45 degree angle during feeding and for 1 hour following the end of the feeding.
Flush tube with 50 cc warm water given over 5 minutes before and after each feeding to keep the tube clean and prevent build-up of medication or tube feedings in tubes which can cause a blockage.
Do not mix medications with feeding formula.
Medications should be given in liquid form if available. If pills are approved to be given through your feeding tube, you may crush finely with either a mortar and pestle or crused between spoons. Mix the powder in water until there are no clumps.
Give each medication separately. Flush tube with 10 cc of warm water between medications.
When you receive your prescription tube feedings, you will get instructions and they will be given to your home health nurse as well, if applicable
NEVER bolus feed a jejunostomy tube - meaning only give fluids throught the tube SLOWLY. Do not exceed 70 cc in 1 hour unless specifically directed by Dr. Kovacev.
Temporary Feeding Instructions:
There are occasionally delays in the delivery of your prescribed tube feedings, so the following instructions are only general guidelines for average sized, weighted patients, and should not be used as an exclusive guide, but rather are general recommendations.
The tube feeding formula above such as Boost / Ensure / or other high protein drink supplements can be used temporarily until your tube feedings arrive. Most average adults can tolerate between 5-6 cans of tube feedings per day with each bootle containing about 240cc of liquid.
If no pump is available, you can place the protein drink into the 60cc piston syringe, and place it into the jejunostomy tube over about 5 minutes, then flush with 10 cc of warm water, then wait 10 minutes. and once again administer an additional 60cc. Repeat the process until the entire 240 cc is given. Flush again with 10cc warm water after the can is complete. Wait 2 hours or longer, then repeat process. Stop if there is any pain, distention, intolerance, nausea, bloating, or if tube feedings come out of jejunostomy tube before next application.
Call Dr. Kovacev or 911 for any of the following:
Chills or temperature over 100.5
Redness, swelling, increased pain, or foul smelling or green drainage around the tube.
If the tube falls out, bring tube with you and go to nearest Emergency Department. Notify Dr. Kovacev
Abdominal bloating, nausea, cramps, vomiting or diarrhea. This may indicate a need to modify your tube feeding formula.
Unable to do feedings.
Increasing size of the hole into your stomach.
Change in overall health: significant weight change, weakness, less urine, dehydration, light headedness, heart racing
Any new, unexplained symptoms.
- 104 Circle Way Suite A - Lake Jackson, TX, 77566, Phone (979) 721-7007, Fax (979) 721-4254 -