25 Invaluable GJ Tips

Recovering from surgery and adjusting to life with a tube can be hard. Sadly, there’s few resources available. For this reason, I’m passionate about helping others with this! I worked with some other tubie friends to compile this list to have it be as complete as possible.

On with the tips!

  1. Immediately following surgery, request heat and ice packs to help with pain around the tube site. Heat under the tube and ice above can be especially useful because it essentially “tricks” the nerves.
  2. Your tube site will be quite sore following surgery, and it can be hard to use your abdominal muscles without causing more pain. One method to go from lying down to sitting up is to bring your knees halfway to your chest, hook both arms under your knees, and with the weight of your legs and arms, lean forward slightly and roll yourself up.
  3. Do not attempt to remove pink HY tape without adhesive remover or alcohol swabs. While it adheres well to the skin, it is extremely harsh to remove it by itself.
  4. Grip loks (REF: 3300M) are great for holding up GJ tube extensions. It keeps both out of the way, but also takes the tension off the stoma. Another benefit is that it’s small and you only need to use it, so I’ve found that it reduces irritation. Some other tapes for extensions are medipore, micropore, mefix, and hypafix.
  5. One trick to cleaning around the stoma is to shower with your gauze and tape on. Once you are out of the shower, just remove the gauze and tape. The wet gauze is like a wipe and will remove the drainage upon removal. After that, touch it up with a q-tip, dry it well, and dress it like normal.
  6. If you have a sore tube site, hold the tube in place to stabilize it while attaching the extensions.
  7. Do not rotate a GJ – it could flip the J portion into your stomach.
  8. If gauze is stuck to the stoma, warm water helps loosen the gauze so it’s easier to remove.
  9. There are several ways to dress your tube, including leaving it open to air, using split gauze and tape, just using split gauze, just using tape, or using a tubie pad.
  10. Use a barrier cream/film to help protect your skin from acid irritation. Cavilon no sting barrier film or zinc-based creams are great options.
  11. Request to have your extensions and syringes be EnFit. They’re hard to accidentally disconnect, which prevents the infuriating phenomenon of “feeding the bed”. If you can’t acquire EnFit, the AMT clamp works well too.
  12. Mepitac tape is great for securing the tube because it is incredibly soft and sticky, but releases from the skin without residue.
  13. If you crush meds, they often settle, and you lose some of the med because it’s stuck on the plunger. A super easy trick is to pull the medication into the syringe and add 2mL of air. Connect it to a clamped extension and give it a good shake. Now hold it upside down and slowly push it as per normal, stopping when you reach the air.
  14. SensiCare makes a great hypoallergenic adhesive remover – it’s unscented and gentle while being effective.
  15. Triamcinolone acetonide can help granulation tissue, itching, and general discomfort
  16. It’s important to remember to flush before and after connecting feeds/medicine. Lower volume, higher pressure flushes are more effective than high volume, low pressure.
  17. You can predose liquid medications, and precrush pills (just wait to add water) if you need/want to prep things in advance.
  18. For crushed medications, a mortar and pestle (made for pills) is much easier to use than the plastic twisty one. With the M&P, you simply drop the pestle onto the pills until they’re broken into small chunks. Then you move it left and right until they become powdery. A way to ensure that you don’t have any large chunks is to rap it on the counter – chunks will come to the top. I also recommend using extremely warm water to dissolve pills, you get a much better solution this way.
  19. Cleaning extensions: I deep clean my extensions once in their one week lifespan (on Wednesday). Here’s my deep cleaning method: I disconnect the extension completely. Then I make a baking soda warm water solution. I use a syringe to pulse this in and out of the extension a few times, then I leave it to sit for just a couple minutes. Next, I place the end of the extensions in some white vinegar and again pulse the syringe to bring the vinegar in and out of the tubing. This breaks down gunk nicely. After that’s done, rinse thoroughly with warm water.
  20. Before connecting your extension, prime it with water so you don’t get excess air in your body.
  21. To vent your stomach, take a 60mL syringe. Remove the plunger and connect it to a clamped gastric extension. Find a comfortable spot to sit or lay down. Holding the syringe upright, unclamp the extension. Wait for a moment and roll on your side or move the syringe up and down to let the air vent. Avoid sharply inhaling, or you will pull air into your stomach. You will know that air is venting when you hear a straw at the bottom of a cup kind of sound.
  22. During a GJ replacement, they insert a wire through the J port. Then they deflate the balloon, pull the tube off, and feed a new one over the wire. Then the wire is removed, and the new balloon is inflated.
  23. Tubie clips are convenient for tying up excessive tubing.
  24. Get a routine! As an example, you can have a flushing routine. After you wash your hands, flush the tube, for example. Or a medicine routine, every time the bag runs out, take your meds. Those connections in your head to things you’ll do anyway make it so much easier to be consistent.
  25. Most button tubes have an anti-reflux valve in the extension ports to prevent GI fluids from leaking when there isn’t an extension in place. However, the valves wear out quickly. One way to help prevent messes is to remove and attach extensions while reclined. Always have gauze to catch the mess if it does leak. Finally, keep the ports always closed or an extension in.

Please make sure to share this post so that it can reach other new tube users. I hope that even one of the tricks will help you in a during this challenging time 🙂