Tuesday, July 28, 2009

Gastrostomy Tube: Maintaining the Stoma

If your child has a g-tube, you will be maintaining the stoma on a regular basis. I have found that direction from medical staff with regard to stoma maintenance is insufficient and largely full of generalizations. To "simply" clean the area with a little saline does not constitute full and appropriate stoma care. This sort of minimal maintenance will lead to infections and hypergranulation around the area.

In general, medical professionals don't care whether or not your child ends up in surgery...to them, everything is a procedure, with risks that they usually under represent and under estimate. For you, avoiding surgery is a life-long struggle, because you and your child are the ones who have to deal with the consequences.

So it goes with the g-tube...so what if you have to move it every now and again, eh? No skin off their noses! Lots of skin and scar tissue, however, for your kid.

What you need to do, then, is always clean the stoma site at least twice a day. I recommend rotating cleaning solutions. Saline once or twice, then a bit of hydrogen peroxide on another day, colloidal silver is very effective against bacteria and viruses, and we even use an old mouthwash called "Glyco Thymoline" which is very alkaline and mild. Then the area must be carefully dried off...I use a cotton swab...and then covered with some sort of cream. As you know (or should know), you should never use ointments around the stoma as they usually contain some sort of petroleum product which will deteriorate the "plastic" of the g-tube. I also rotate my creams. Polysporin cream is good, as is a Calendula cream, Traumeel or Arnica homeopathic creams are excellent and sometimes I just leave the site clean and dry to give the skin a break. If there is some leakage around the site with burning from stomach acid, Calmoseptine is the absolute best stuff and it is a very natural skin barrier. Once clean, I cover the area with a 2"X2" drain sponge.

When you get an infection, you are likely to be given a prescription for Fucidin (Fusidic Acid) which is a topical antibiotic. Using this occasionally is OK, and it really takes away the pain of infection. Bear in mind, however, that the frequent need for Fusidin means your cleaning routine isn't aggressive enough. What you are doing, furthermore, is simply driving the infection away from the site and into the body. It doesn't just go away and disappear. Likely it'll show up somewhere else...lungs, skin rash, UTI...keep an eye out. If you are frequently cleaning the site and infection keeps showing up, something is wrong somewhere else. Try to get to the bottom of it. Infection will show up at the weakest site in the body. Pay attention to other parts of the body.

At one point, we were having lots of trouble with granulomas or hyper-granulation around the stoma. Gross little protuberances (that would get bigger) with roots kept popping up around and from inside the stoma tract. We were warned that this would eventually lead to surgery and the creation of a new hole somewhere else....and that there was nothing that could be done about it. Well, you should know by now that I don't believe in that, so, of course, we found a solution!!

Enter a homeopathic product called Pleo*San STAPH Drops 6X. We got this from our naturopathic doctor. She said it had been used in cases of gangrene...topically...and actually drew the sickness out of the limb until it healed. If you don't go to a naturopath, it is possible to order this product online. It is a TINY bottle...only 10mls...and it costs round about $45 Canadian, but it is well worth saving your child from surgery. Plus you only need 2 drops onto the stoma site, twice a day, directly on any granulomas. This will draw the pustule up higher out of the tract and then a physician can burn it off with silver nitrate (it's good to do this when the actual g-tube is out, like when you are putting in a new one, but it's not necessary). Let the burn heal and then go back to using the Pleo San until you don't get any more granulomas. This has been wonderfully successful for us and we have never had to change her g-tube site, after almost 10 years.

Finally, it is good to drain the saline balloon every now and again and rinse the stoma with saline, making sure it goes right down the tract. This allows any gunk that has accumulated around the balloon between it and the stomach lining to be rinsed away. You can use colloidal silver for this as well, and put fresh saline into the balloon.

Hope this was of some help.

3 comments:

  1. I am also the mom of a severely handicapped child. I care for her 24/7 with no help at all. It can be daunting. I'm glad I found your site.

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  2. Hi Susan. Welcome to the blog. You certainly have your work cut out for you. I consider myself very lucky to have as much help as I do.

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  3. I love your site, so much GOOD useful info!!!! Thank you! God bless you for your excellent care of your daughter, I always feel really blessed to hear someone express value for the ones Jesus called "one of the least of these" In our throw away, self centered society it isn't seen too often. We are having some g-tube irritation problems and I'm finding your ideas wonderful!

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