Some patients with gastrostomy tubes are prone to getting problems with the site. Help should be sought early from community nursing teams to try to correct the problem and not let it become too severe.

  Indication Possible causes Treatment
Infection Pain.
Redness.
Exudate.
Malodorous.
Pyrexia.		 Poor hygiene.
Immunocompromised.
Malnutrition.
Cross infection.		 Ensure good hygiene.
Swab site.
Liaise with medical staff re: antibiotic treatment.
Consider dressing.
Over-granulation Overgrowth of red/pink, fleshy, tissue/ Incorrect position of external fixation device.
Rubbing of the tube.
Infection.

Ensure good hygiene.
Ensure fixation plate is 2-3mm from skin surface.
Swab if clinically indicated.
Double thickness polyurethane dressing.

Consider use of honey dressings, Corticosteroid, or possible surgical removal. 

Gastric leakage

Acid burn

 Pain.
Redness of skin.		 Incorrect position of fixation devices.
Delayed gastric emptying.
Constipation.
Infection.
Buried bumper.		 Test leakage with pH to confirm gastric acid.
Clean and dry regularly.
Ensure correct position of fixation device.
Consider barrier film/cream.
Candida / Fungal infection Itchy rash.
Moisture.
Creamy white pustules.		 Poor hygiene.
Antibiotic therapy.
Moist skin.
Immunocompromised.		 Clean and dry regularly.
Swab stoma site.
Antifungal treatment plus corticosteroids if inflammation present.
Buried bumper syndrome (PEG only) Peri-stomal leakage.
Abdominal pain.
Inability to flush or feed via tube.
Inability to advance tube.		 Fixation device too tight.
Rapid weight gain.
Thick dressing under fixation device.
Poor aftercare - particularly no regular advancing.

If buried bumper is suspected then feeding should be discontinued, the tube should not be rotated, and advice should be sought immediately from the dietitian.
 

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For office use only: Version 4 GU_TS003 Publication date: May 2026