Tube Talk

Thank you to everyone who sent material for the "Tube Talk" column. Anyone who is interested in participating can send their tips, questions and thoughts about tube feeding to: Tube Talk, c/o The Oley Foundation, 214 Hun Memorial A-28, Albany Medical Center, Albany, NY 12208; or E-mail DahlR@mail.amc.edu. Information shared in this column represents the experience of that individual and should not imply endorsement by the Oley Foundation. The Foundation strongly encourages readers to discuss any suggestions with their physician and/or wound care nurse before making any changes in their care.

Device allows feeding tube to go through an ostomy bag without leakage.

This tip is applicable to a small, very specialized portion of our tube-feeding readers and should be discussed with your physician before trying.

Most physicians see important advantages to a patient using their gastrointestinal tract, even if accessing it is somewhat complicated. For example, tube feeding is sometimes done through a small bowel ostomy that is also the site of some secretions, and thus requires an ostomy bag for collection. This might happen if the patient has a pull-through small bowel ostomy and feeding into the more distal bowel is desirable, or if the patient has a Roux-en-Y feeding jejunostomy.

The challenge is to insert the feeding tube through the ostomy bag and avoid any leakage onto the skin. This can be achieved by gluing a "universal catheter access port" (a soft white cone) into the ostomy bag. A consumer in upstate New York developed a simple technique for this process which is described and illustrated below. Using the port allowed him to insert his tube for overnight feeding and remove it during the day, without compromising the functionality of his ostomy bag which only needed to changed every five to seven days.

Equipment Needed:

  • universal catheter access port (Hollister, #HOL 9779) that includes:

- the port itself (a soft white cone)
- hard plastic blue cone for inserting the port
- plastic rings, inner and outer, to help hold the port in place

  • approximately 4" long block of 2" x 4" wood, with a hole the diameter of the port’s outer ring drilled through it
  • wooden dowel, or end of a broom handle
  • super glue
  • ostomy bag

Gluing the Port into the Ostomy Bag

1. Put the outer ring on the port (soft white cone) and place them tip down into the hole in the wooden block. (The block is used to hold the port and outer ring in place while gluing.)

2. Next, place the ostomy bag face (hole-side) down, on top of the port on the block, centering the bag’s hole over the port.

3. Place the inside ring on the hard blue cone, then carefully apply a small amount of super glue to the exposed surface of the inside ring.

4. Using the wooden dowel for pressure, poke the blue cone (tip side down) through the back side of the ostomy bag and into the white cone. This action will make a hole in the ostomy bag, and leave the port sandwiched between the inner and outer rings.

5. Hold in place until the glue sets (about 1 to 2 minutes). Remove the blue cone.

6. Snip the tip of the port carefully, to make a hole just large enough to fit the feeding tube through.

To change the ostomy bag and/or prepare for a feeding, attach the ostomy bag to your body. Then insert the feeding tube through the hole in the back of the ostomy bag, through the port, and into the distal bowel until it reaches the length indicated by your physician.

For photos and two slightly different approaches to this adaptive technique, please see “Feeding through an Ostomy Bag Using a Universal Access Port” and “An Alternative Using a Baby Bottle Nipple.