Feeding tube site problems: infection and granulation tissue
How to tell feeding tube granulation tissue from an infection — the signs of each, how to prevent them by keeping the site clean and dry, and when to call your team.
Reviewed by the Lugano Health team
Granulation tissue is moist, bumpy, pink-to-red tissue around the tube site that can bleed a little — it's common and treatable, so report it to your care team. Infection is different: spreading redness, warmth, swelling, pus, a bad smell, fever, or increasing pain mean you should call your team. Keeping the skin clean and, above all, dry prevents most site problems. When in doubt, it's always okay to check in.
- Granulation tissue is moist, bumpy, pink-red tissue that's common, treatable, and worth reporting to your team.
- Infection signs are different: spreading redness, warmth, swelling, pus, bad smell, fever, or increasing pain.
- Prevention is mostly keeping the site clean and — most importantly — dry.
- Spreading redness, pus, fever, or a hard, painful area means call your care team promptly.
The skin around a feeding tube — the stoma — settles down for most people, but two things can come up: granulation tissue and infection. They can look similar at a glance, so this guide walks through how to tell them apart, how to prevent both, and when to pick up the phone.
Granulation tissue (common and treatable)
Sometimes the body grows a little extra tissue around the site as it heals. This is granulation tissue, and it's:
- Moist, bumpy, and pink to red
- Prone to bleeding a little or oozing clear-to-pinkish fluid
- Apt to catch on clothing and feel tender when bumped
- Usually right at the opening, not spreading outward
It looks worrying the first time you see it, but it's common and treatable. Keep the area clean and dry and let your care team know — they can recommend treatment and rule out other causes. Don't try to remove it yourself.
Infection (call your care team)
Infection is different from granulation tissue. Instead of staying at the opening, it tends to spread outward and make you feel unwell. Watch for:
- Redness that is spreading away from the site
- Warmth and increasing swelling
- Pus or a bad smell
- Increasing pain rather than pain that's settling
- Fever or feeling generally unwell
Any of these deserve a call to your care team. Infections are very treatable, especially when caught early — the key is not waiting to "see if it settles."
Site signs and what to do
Prevention: clean and, above all, dry
Most site problems come down to one thing — moisture trapped against the skin. Keeping the area clean and dry prevents both granulation and infection far more than any product does:
- Wash your hands, then clean gently around the tube with warm water daily.
- Pat the skin completely dry afterward. This is the most important step.
- Skip heavy creams and powders unless your team recommends them.
- Keep the tube secured so it doesn't tug or rub, which irritates the skin.
- Glance at the site each day so you notice changes while they're small.
For the full daily routine, see Caring for your feeding tube site, and if you're also seeing fluid around the tube, Feeding tube leaking.
When to call your care team
Reach out promptly for:
- Spreading redness, warmth, or increasing swelling
- Pus, a bad smell, or increasing pain
- Fever or feeling unwell
- New or growing granulation tissue, or bleeding that doesn't settle
None of this means you did anything wrong — skin around a tube just needs a little attention, and your team would always rather hear from you early. When in doubt, check in. For the bigger picture, start with Feeding tubes made simple.
Frequently asked questions
- Stoma and enteral access site care — American Society for Parenteral and Enteral Nutrition (ASPEN)
- Skin and site care resources — The Oley Foundation
This article is educational and is not medical advice. Every person and every tube is different — always follow the instructions of your own care team, and call them (or emergency services) if something feels wrong.
