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Granulation tissue around a feeding tube | CION Cancer Clinics
Red, moist, bumpy tissue around a PEG tube is most likely granulation tissue: extra healing tissue that grows when the tube rubs or the site stays damp. It is common, bleeds easily and is usually not infection. The nurse or doctor can nearly always treat it without taking the tube out. This page explains what it looks like, how it is treated, and when it needs a closer look. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- What is the red, bumpy tissue around the PEG tube?
- How is granulation tissue different from infection?
- How is granulation tissue treated?
- What helps stop it coming back?
- What do families believe about this tissue?
- What do the words the nurse uses mean?
- When should it be seen, and what can this page not tell you?
- Common questions about granulation tissue around the tube
The short answer
What is the red, bumpy tissue around the PEG tube?
It is most likely granulation tissue: extra healing tissue that grows around the tube opening when the skin keeps getting rubbed or stays damp. It is common, it is not usually infection, and it can nearly always be treated by the nurse or doctor without removing the tube.
Why it grows
When skin heals, it lays down soft, pink tissue full of tiny blood vessels. Normally this stops once the wound is closed. Around a feeding tube, the opening never fully closes, and every movement of the tube tells the body to keep healing. The result is a moist, raised, bumpy ring that can keep growing.
Why it is a nuisance
It is fragile and bleeds easily when touched or cleaned, which frightens many families. It can make a sticky, pale or blood-stained discharge that stains clothes. It can be sore. It can also make the tube fit less well, which leads to leaking.
Seeing a small amount of blood on the gauze when cleaning granulation tissue is common. Bleeding that does not stop with gentle pressure is not, and needs to be seen.What you are seeing
How is granulation tissue different from infection?
They can look alike and can happen together. These are the usual differences, not a way to diagnose it yourself.
Granulation tissue
A raised, shiny, pink or bright red lump or ring right at the edge of the tube. It looks wet and bumpy, bleeds easily, and the skin further out usually looks normal.
Often comes with
- Clear or pale sticky discharge
- Spotting of blood on cleaning
Infection
Redness that spreads out across the skin, feels hot or swollen, and is increasingly painful. There may be yellow or green pus, a bad smell or fever.
Fever or spreading redness needs a call the same day.Skin irritated by leaking
Flat, sore, red skin where stomach fluid has leaked out and burned it. It is usually wet and may peel. It is not raised like granulation tissue.
Something that needs a closer look
A hard, fast-growing or irregular lump that does not respond to the usual treatment. Rarely, in people with head and neck cancers, cancer can grow at the tube site. The team may take a small sample, called a biopsy, to check.
Not sure whether this applies to you?
Ask an oncologistTreatment
How is granulation tissue treated?
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Find the cause of the rubbing
The nurse checks how well the tube is secured, whether the outer disc is too loose or too tight, and whether the tube swings when the person moves. Fixing the fit is the most important step, or the tissue simply grows back.
-
Keep the site dry
Cleaning, drying thoroughly and changing damp dressings often helps small patches shrink. A foam dressing that holds the tube steady may be used.
-
A prescribed cream
The doctor may prescribe a steroid or antibiotic cream for a short time. Use only what was prescribed, exactly as directed, and stop when told.
-
Silver nitrate
A nurse or doctor touches the tissue with a stick tipped with silver nitrate, which shrinks it. It can sting briefly and turns the tissue grey or black. It may need repeating over a few visits. This is not for use at home without training.
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Changing the tube
If the tissue keeps returning, a different size or type of tube may fit better. Removing the tissue in a small procedure is rarely needed.
Every day
What helps stop it coming back?
- Tape the tube to the skin so it does not swing or pull
- Clean the site daily and dry it completely
- Change any dressing as soon as it is damp
- Keep the outer disc at the fit the nurse set
- Wear loose clothes that do not rub over the tube
- Tell the team early if a small bump appears
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Commonly believed
What do families believe about this tissue?
"It is the cancer coming out through the tube."
Granulation tissue is healing tissue, not cancer, and it is very common. Cancer growing at a tube site is rare. If a lump behaves unusually, the team can check it, and that is a far better answer than worrying at home.
"We can tie a thread around it or snip it off."
This tissue is full of tiny blood vessels and bleeds heavily when cut. It also grows back if the rubbing is not fixed. Treatment belongs with the nurse or doctor.
"Toothpaste or salt will dry it up."
These irritate the skin, can damage the tube and may introduce germs. They do not deal with the cause. Clean water, careful drying and the team's treatment work better.
"It means the tube has to be taken out."
Almost always the tube stays. Better fixing, a dressing, a prescribed cream or silver nitrate usually settles it. Changing the tube is kept for tissue that keeps coming back.
On the nurse's notes
What do the words the nurse uses mean?
- Overgranulation or hypergranulation
- Other names for granulation tissue that has grown too much around the tube.
- Stoma site
- The opening in the skin where the tube goes into the stomach.
- External fixator or disc
- The flat plastic piece on the outside that stops the tube sliding in.
- Silver nitrate
- A chemical on a stick that shrinks the extra tissue when a nurse applies it.
- Exudate
- Fluid coming from the site, which may be clear, pale or stained with blood.
Being straight with you
When should it be seen, and what can this page not tell you?
Have granulation tissue looked at when you first notice it, even if it seems small. Small patches are quicker and easier to settle than large ones.
Call the team the same day if
There is bleeding that does not stop with gentle pressure, spreading redness, pus, fever, feed leaking out, or pain when feeds go in. These are not granulation tissue alone, and they need a same-day check.
Ask for a review soon if
The tissue is getting larger, is sore, keeps coming back after treatment, or feels hard. Mention if the person has had head and neck cancer, so the team knows to look carefully.
What this page cannot do
It cannot tell whether the bump you are looking at is granulation tissue, infection or something else. A photograph can help the nurse, but it does not replace having the site examined.
Questions we are asked
Common questions about granulation tissue around the tube
Is granulation tissue around a PEG tube dangerous?
Usually not. It is a common, harmless overgrowth of healing tissue. It can be sore, bleed easily and make the tube leak, so it is worth treating. It needs a same-day check only if there is fever, spreading redness, pus or bleeding that will not stop.
Why does it bleed every time I clean it?
The tissue is full of tiny blood vessels close to the surface, so even gentle wiping can make it spot. Pat rather than rub, and use soft gauze. A little blood on the gauze is common. Bleeding that soaks through or does not stop with gentle pressure should be seen.
Does silver nitrate treatment hurt?
Most people feel a brief sting or burning as it is applied, which fades. The tissue turns grey or black afterwards, which is expected. The nurse protects the surrounding skin. It may need doing more than once. Tell the nurse if the stinging lasts or the skin around it becomes sore.
Can I buy a steroid cream for it?
Please do not use a cream without the team seeing the site first. If it is infection rather than granulation tissue, a steroid cream can make it worse. If a cream is prescribed, use it only as directed and for as long as the doctor says.
Will it go away on its own?
Small patches sometimes settle once the tube is better secured and the site kept dry. Larger or growing patches rarely clear without treatment, and the longer they stay, the harder they are to settle. Having it seen early usually means simpler treatment.
Can granulation tissue cause the tube to leak?
Yes. The extra tissue can push the tube at an angle and stop the outer disc sitting flat, which lets fluid escape. Leaking then keeps the site damp, which feeds more tissue growth. Treating the tissue and fixing the fit together usually breaks that cycle.
He had head and neck cancer. Could this be the cancer?
It is very unlikely, because granulation tissue is so common. Cancer growing at a tube site is rare, but it is known after head and neck cancers. That is why a hard lump, or one that does not settle with treatment, should be checked, sometimes with a small sample.
Does changing the tube stop it for good?
A tube that fits better removes the rubbing that causes the tissue, so it often helps a lot. It is not a promise the tissue will never return, especially if the person's weight changes. Keeping the tube secured and the site dry is still needed after a change.
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Sources
- Cancer Research UK — Diet problems with cancer
- National Cancer Institute — Nutrition in Cancer Care (PDQ) - Patient Version
- Macmillan Cancer Support — Impacts of cancer: eating and drinking
- NICE — Nutrition support for adults (CG32)
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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Noticed tissue growing around the tube?
Call the helpline to arrange for a nurse to see the site. Small patches settle faster. One helpline serves every CION centre.