Patient presents with symptoms suggestive of gastrostomy tube malfunction.  These include difficulty with gastrostomy tube feeding administration,  manifesting as increased resistance during bolus feeding or continuous feeding infusion, as well as possible reflux of formula or medication.  The patient may also exhibit signs of discomfort, such as abdominal distension, nausea, vomiting, or gagging during tube feeding attempts.  Assessment of the gastrostomy tube site revealed (describe findings, e.g., erythema, edema, leakage, granulation tissue, displacement).  Aspiration of gastric contents was performed, yielding (describe amount and character of aspirate, e.g.,  minimal clear gastric contents, large volume of undigested formula).  Tube patency was assessed by flushing with (amount) of (type of fluid), revealing (describe findings, e.g., easy flow, resistance to flow).  Differential diagnosis includes tube obstruction, tube displacement, tube kinking, and gastrointestinal dysfunction.  Plan includes troubleshooting the gastrostomy tube malfunction by checking for tube kinks and repositioning the patient.  Considered interventions include further evaluation with a KUB x-ray to assess tube placement and rule out obstruction.  If blockage is confirmed,  tube replacement or further intervention by gastroenterology may be necessary.  Patient education provided regarding gastrostomy tube care and maintenance, including proper flushing techniques and signs and symptoms of malfunction.  Follow-up scheduled with (provider/specialty) in (timeframe).  Diagnosis: Gastrostomy tube malfunction.