There are two types of leakage commonly encountered with feeding tube stomas: leakage of secretions from the stoma, and leakage of formula/stomach contents. Button-style tubes may also be prone to leakage from the button itself.

Normal Secretions

In general, a small amount of leakage of secretions from the stoma is considered normal. These secretions are usually tan or clear in color, and may become crusty when they dry. Dry secretions can be removed with a wet Q-tip or washcloth. Secretions are usually worse when granulation tissue is present. Drying out the site by keeping it uncovered and open to the air may help diminish these secretions. G-tube pads or gauze may also be used to absorb secretions. Secretions may be increased in children with separate J-tube sites. If leakage is severe or skin irritation is occurring, consult your doctor or a wound care nurse.

Leakage of Formula or Stomach Contents FROM the Tube

Leakage of formula and stomach contents from a button-style tube itself typically signals that the anti-reflux valve is no longer working properly. Note that many buttons have anti-reflux valves that break quite quickly, sometimes within days or hours. If the button leaks every time you open it, try flushing with warm water to see if that stops it. If you give medications directly into the button, sometimes the syringes cause the valve to be stuck open, which can also be fixed with flushing. If flushing does not help, the anti-reflux valve may be worn out and it may be time for a new button.

When only minor leakage is occurring, you can still use the button, but make sure to close the button after use, and cover the opening in the button when connecting and disconnecting the extension set to prevent leakage. You may also want to keep an extension tube attached at all times. Once leakage from the button becomes severe, replace the button.

Crusty secretions with granulation tissue

Leakage of Formula or Stomach Contents AROUND the Tube

Leakage of formula or stomach contents from the tube site (around the tube or button) is more concerning because nutrients may be lost, and the acid from stomach contents may damage skin. Leakage of formula or stomach contents is not considered normal. It may be more likely to occur in children with J-tubes, children with connective tissue or skin disorders, and children with tubes that do not fit correctly.

Common causes of leakage from around the tube:

  • Wrong size tube or button
  • Uninflated or partially inflated balloon in a balloon button
  • Stretched-out or damaged tube site
  • Severe dysmotility

To eliminate leakage, first make sure your child has the right size tube as prescribed by the doctor, and that the balloon is properly inflated in a balloon-style button or tube. You can learn more about checking the balloon on our Living with a G-tube page. If the tube size does not look correct, consult your physician to have your child resized. Information on sizing is available on our G-tube page.

You should always consult your child’s physician if formula or stomach contents are leaking around the tube and you cannot resolve it by replacing the tube or properly inflating the balloon. Sometimes, sites become stretched out and may need to be tightened. In other cases, when extreme dysmotility and pressure causes leakage, venting or draining the stomach may be necessary. Your child’s doctor can help you determine the cause and a treatment. In rare cases, an ostomy or wound nurse, who specializes in the care of stomas or wounds, may be required to treat leakage.