When a patient is unable to consume food on a long-term basis, a feeding tube may be required. A percutaneous endoscopic gastronomy (PEG) tube must be surgically inserted through the abdominal wall and into the stomach. Unfortunately, infection is a significant risk associated with a PEG tube. Infection can strike at any time, particularly in the days immediately following the insertion of the feeding tube. The following methods can be used to detect a feeding tube infection.
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Begin by examining the skin surrounding the port where the feeding tube enters the body. Look for redness, inflammation, discharge, and (in some cases) a foul odour. In the days immediately following surgery to insert the PEG tube, there is an especially high risk of infection.
Check the patient's temperature. Normal temperature is 37 degrees Celsius. A person with an established and potentially life-threatening infection will have an elevated temperature. It's important to note that a patient with a less serious infection may not present with a fever until the infection worsens.
Check for abnormal stool, particularly stools that are black in colour or very loose (diarrhoea). When a patient with a PEG tube develops an infection, the bacteria from the infection will travel "downstream" into the intestines. This will cause the intestines to become inflamed; the inflammation inhibits the body's ability to absorb fluid from the meal and the stool will emerge in the form of diarrhoea. In more severe cases, the intestines will begin to bleed as a result of the bacteria and inflammation. This causes bloody stool or a black stool. Black stool indicates bleeding in the upper GI tract, while red blood is "fresher," indicating bleeding in the lower GI tract.
Look for symptoms of abdominal pain and nausea. A patient with a feeding tube infection will experience pain, discomfort and nausea. In young children or babies who cannot "report" pain, look for increased irritability, more frequent crying, and other signs of discomfort.
If a feeding tube infection is suspected, immediate medical attention is required, so transport the patient to the nearest hospital emergency room for care. If left untreated, infection can kill portions of the stomach, intestines and other organs, leading to a condition called necrosis. The infection can also enter the blood stream, causing a potentially deadly condition called sepsis.
Tips and warnings
- In the days following the surgical procedure to insert the PEG tube, clean the wound at the site of the port--the spot where the tube enters the body--several times per day as directed by the physician.
- When caring for a person with a feeding tube, always err on the side of caution if a problem is suspected. Feeding tubes can become dislodged, infections can occur and these problems can be life-threatening. Seeking immediate medical care is essential if a problem is suspected.
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