FEATURES: 1991 OUTSTANDING PAPER AWARD: PDF OnlyPractical Considerations of the Gastrostomy ButtonTOWNSEND, LOIS C., RN, BSNAuthor Information Received November 21, 1990. For revision January 23, 1991. Accepted April 8, 1991. About the author:Ms Townsend has worked in the area of gastroenterology for the past 8 years, first as a general staff nurse in endoscopy, then as the pediatric gastroenterology nurse and gastrostomy nurse at the University of Minnesota Hospital and Clinic in Minneapolis. She plans to begin graduate school in Fall 1991. Address correspondence to: Lois C. Townsend, RN, BSN, Box 88, Endoscopy, The University of Minnesota Hospital and Clinic, Harvard at East River Road, Minneapolis, MN 55455. Gastroenterology Nursing: August 1991 - Volume 14 - Issue 1 - p 18-26 Buy Abstract Low-profile gastrostomy replacement devices (LPGRDs), also called gastrostomy buttons, provide patients with a desirable alternative to traditional catheters. Contraindications to LPGRDs include acutely angled gastrostomy tracts, tracts created with a mucosa lining, the need for jejunal feedings or significant decompression, planned retroesophageal dilation and tracts that are longer than the LPGRDs. Gastrostomy and patient considerations lead to a variety of scheduling practices. Management adaptations help maintain LPGRD patency and functioning of the anti-reflux valve and plug. Other adaptations are necessary for patients receiving thickened feedings or medications per gastrostomy, needing intermittent decompression or having high intra-abdominal pressure. Determining the correct LPGRD size and dilating the tract or cauterizing conclude this discussion which is summarized in a checklist following the text. © The Society of Gastroenterology Nurses & Associates 1991. All Rights Reserved.