PEG care

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soonerwife

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My PALS had his feeding tube put in 5 days ago.

Are you supposed to rotate the bolster every time you clean the stoma? Today when I cleaned it, the bolster didn't want to turn, it seems tighter to the skin and the skin was a little red around it. When I tried to turn it, PALS said it hurt a little. A little of the contents in the tube leaked out around the stoma.
 
Rotate daily, yes. Like 1/4 turn.

A little leakage is ok.

If it won't turn freely you might need to det it looked at.
 
The bolster/bumper/flange doesn't usually get tighter to the skin, but it is likely that his is being pulled in by the return of good function of the stomach. It can get pretty active and tug the inner bolster or balloon in. I really notice mine being tugged on when my stomach growls! The bolster doesn't need to be tight to the skin. It helps reduce the movement of the tube if it is close, but it shouldn't be so tight as the cause skin redness. The bolster is soft plastic ring, triangle, or pair of wings that is not actually attached to the tube. To back it away from the skin, simply lift the opposite edges of the bolster and pinch them up against the tube. This will open the hole in the bolster and allow it to be slid along the tube. It may stick at first and you need to be careful not to tug on the tube, but with gentle manipulation, it will move and the pain relief will be nearly instant.
 
Thanks guys! Good tips!
 
Oops. Didn't manage to post the second paragraph! If the redness isn't being caused by a tight bolster, the leaking stomach contents are acidic and may cause redness and discomfort. Apply an antacid liquid or make a paste of crushed Rolaids or Tums. If the redness is on or in the stoma itself, try a dab of non-prescription cortisone cream to shrink away any granulation tissue that might be forming. Regardless, stop using peroxide as it can encourage granulation. Soap and water is just as antibacterial (even without the added antibacterial stuff the FDA is finally banning ). If it is red and itchy on the skin around the stoma, try athletes foot/jock itch cream. Of course, if the redness continues or gets worse, you'll need to call your doctor.
 
Thanks Diane! We found out today that the reason the tube tightened up was because my PALS has gained a few pounds which was a pleasant surprise. I was so worried. He tried squeezing the bolster and adjusting like was suggested but it wouldn't budge. I called his GI Dr and he had us come by the hospital and he adjusted it for us. Thanks for all the info. I am hoping things will get better now.
 
That's great news.
 
Glad you got that sorted and so great he has already put some weight on!!!
 
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