TABLE 3.

Some common tube problems, possible solutions and prevention

Problem	Possible cause	Action	Prevention
Patient is gagging	Esophagitis	Treat esophagitis (sucralfate, omeprazole)	Check tube care and feeding regime
	Stoma infection (bacterial/fungal)	Culture from stoma, treat infection as required	Clean or replace tube more often
	Tube, antiseptic or other topical preparation allergy	Replace tube	Consider history of allergy
Patient constantly tries to remove tube	Stoma infection (bacterial/fungal)	Culture from stoma, (bacterial and fungal) and treat infection	Check cleaning regime and home hygiene
	Possible reaction to tube material or wrap	Use a different wrap and tube make or remove tube	Consider history of allergy
	Allergy to topical antiseptic or barrier cream	Change cleaning products
Discharge from stoma	Stoma infection, bacterial/fungal	Culture stoma site, treat infection	Check cleaning regime and home hygiene
	Tube is incorrect size	Remeasure and replace tube with correct size	Replace tube on time
Food material coming from stoma	Tube is too small	Replace tube with appropriate size	Replace tube on time
	Stoma infection (bacterial/fungal)	Culture stoma site, treat infection	Check cleaning regime and home hygiene
			Use barrier cream with an ostomy pad
Tube blocked	Tube kinked (uncommon)	Remove and inspect or replace tube	Antikink tubing (AMT G‐Jet)
	Food obstruction	Clear obstruction using a tube cleaning brush	Use appropriate diet and water flush after feeding
Tube becomes discolored or material is distorted	Discoloration by topical agents for example, iodine	No action if tube is normally functional	Use optimal cleaning regime
	Tube material is degraded	Inspect and/or replace tube	Replace tube on time
	Tube is infected for example, fungal infection	Culture from stoma (bacterial and fungal)	Prophylactic application of topical antifungal
Button cap is frequently found to be open	Defective or old tube	Replace tube as soon as possible	Prevent gastric dilatation by taping cap closed and use neck wrap