Stoma site care

A gastrostomy stoma is a direct hole into the stomach in which the feeding tube is placed through. As dietitians, support carers, family of, or people with a feeding tube, it’s best you know what the daily care of a stoma site actually entails. And I promise you, it’s not that complicated!

So we went straight to an expert and trusted colleague, Megan Murray. Megan has been a Dietitian for 30 years and is PEG credentialed (which means she has extra powers of being able to change feeding tubes as a dietitian). She works at Monash Health in both acute and community settings, as well as the aged and disability sector.

So below are Megan’s gems to some simple questions we asked her about stoma site care.

Disclaimer: Please note the information provided below is NOT intended to be medical advice nor does it replace your health care professionals advice. It is only intended to raise awareness and we recommend you discuss any questions you have about your stoma site and about any of the products we mention below BEFORE using them, with your health care professional first and foremost.

What does basic daily stoma site care entail?

  • Hand Hygiene before and after touching the stoma site, then wash the area with a soft cloth and soap and water daily in the shower or bath
  • Keep the area dry
  • Make sure to remove any crusty bits
  • Rotate the tube 360 degrees daily (note: do NOT rotate tubes that go into the small intestine)
  • Apply barrier cream, such as Sudocream, if red
  • Ensure skin flange/disc on the tube has a distance of 2-5mm (about a coins width) from the abdomen

What are the “red flags” to look out for in a stoma site?

Very red and sore, swollen stoma and surrounding area, green, smelly discharges can be a sign of infection and if you have a fever, you need to see the GP.

Hype granulation (skin growth around the tube) is very common at a stoma and will give off a thick yellowish discharge and can bleed – most of the time, this is normal and not infected and the tissue can be treated with a cream and appropriate dressing. However, best to always get it checked by your healthcare professional first.

When do I need to see a doctor for my stoma site?

If the area is sore and you have a fever, see your GP immediately so they can do a swab and decide if antibiotics are required.

How often should a professional review my stoma site?

With appropriate daily care, a stoma site would only need review 2 x per year but of course can be more frequently if concerns arise.

Should a stoma site be covered all the time? If yes/no, why?

No, we recommend that you leave the stoma site uncovered as it needs air to keep healthy, clean and dry.

What are some over the counter creams or tablets that I will likely need in my home tube feeding journey to ensure my stoma site stays healthy?

  • a barrier cream such as Sudocream to apply if the area is a bit red,
  • AMD excilon antimicrobial dressings – these help with hypergranulation and keeping discharge at bay, and
  • hydrozole cream for hyper granulation tissue only.

*Please consult your healthcare professional before using any of the above mentioned products on your stoma site. And if you are a dietitian that regularly works with people with a feeding tube, please familiarize yourself with these products.

And that’s it! In summary, stoma site assessment must become a standard part of every dietitians assessment, and daily stoma site care must be engrained in us as tooth brushing is. A reliable and freely available resource for everyone can be found here.

Happy reading and home tube feeding,

Lina Breik.