(PEG)
Definition
Definition
Percutaneous endoscopic gastrostomy (PEG) is a procedure to place a tube through the abdominal wall and into the stomach.
Reasons for Procedure
Reasons for Procedure
A gastrostomy tube provides an alternative feeding site. It may be needed to:
- Feed a person who has a hard time sucking or swallowing, or who is otherwise unable to eat
- Drain the stomach of fluids that have built up
Possible Complications
Possible Complications
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- PEG tube malfunction
- Aspiration—accidental sucking into the airways of fluid, food, or any foreign material
- Damage to other organs
- Inflammation of the lining of the abdomen
- Infection
- Bloating
- Nausea
- Diarrhea
- Irritation of the skin near the tube
- Blockage
- An abnormal opening between two structures—fistula
Factors that may increase the risk of complications include:
- Chronic disorders, such as obesity or diabetes
- Smoking
- Alcohol use disorder or drug abuse
- Use of certain prescription medications
- Prior abdominal surgeries
- Increased age
What to Expect
What to Expect
Prior to Procedure
Your doctor may do the following:
- Physical exam
- Medical history
- Review of medications
- Blood and urine tests
- X-rays of the abdomen
- Endoscopic examination of stomach—An endoscope is long tube with a camera at the end that can be put down the throat into the stomach.
Leading up to your procedure:
- Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
- Do not have nutrition or fluids for at least 8 hours before the procedure.
- Arrange for a ride to and from the hospital.
Anesthesia
- Local anesthesia—usually a lidocaine spray to numb the throat
- Pain medication is usually given with an IV
- To help you relax, you may be give a sedative
Description of the Procedure
You will be given antibiotics for the procedure.
An endoscope is a long thin tool with a light and camera. It will be inserted through your mouth, down your throat, and into your stomach. The camera will send images to a video monitor. The images will be used to find the right spot to insert the PEG feeding tube.
A needle will be inserted through the abdominal wall and into the stomach at the chosen spot. Using the endoscope, the doctor will locate the end of the needle inside the body. A thin wire will be passed from the outside of the body, through this needle, and into the stomach. This wire will be grasped with a snare in the abdomen and pulled out through the mouth. There will be a thin wire entering the front of the abdomen, going into the stomach, and continuing up and out of the mouth. The PEG feeding tube will then be attached to this wire. The wire will be pulled back out from the abdomen. This will pull the PEG tube down into the body.
A small incision will be made in your abdomen. The tube will be pulled until the tip comes out of the incision in the abdominal wall. A soft, round bumper will be attached to the ends of the PEG tube. It will keep the tube secure. Sterile gauze will be placed around the incision site. The PEG tube will be taped to your abdomen.
Percutaneous Endoscopic Gastrostomy ProcedureCopyright © Nucleus Medical Media, Inc.
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How Long Will It Take?
30-45 minutes
Will It Hurt?
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
Average Hospital Stay
The usual length of stay is one day. Your doctor may choose to keep you longer if complications arise.
Post-procedure Care
At the Hospital
The hospital staff will monitor your breathing, heart rate, and pulse. Care may include:
- Medications to prevent pain or blood clots
- Elevating your legs while in bed
- Moving around to as soon as possible to promote healing
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered and PEG tube protected
There are also steps you can take to reduce your chances of infection such as:
- Washing your hands often and reminding visitors and healthcare providers to do the same
- Reminding your healthcare providers to wear gloves or masks
- Not allowing others to touch your incisions or the PEG tube
At Home
A dietitian will teach you how to use your PEG tube. You will also be taught how to choose an appropriate tube-feeding formula.
The hospital staff will teach you how to take proper care of the PEG tube. This includes changing the dressing, cleaning the around the site, and monitoring for infection.
You may be given medications to ease pain or other symptoms. Follow any instructions on exercises to help with your recovery.
Call Your Doctor
Call Your Doctor
It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:
- Pain that you cannot control with the medications you’ve been given
- The tube falls out
- Problems with the function of the tube or drainage around the tube
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge from the gastrostomy site
- Headaches, muscle aches, lightheadedness, or general ill feeling
- Nausea, vomiting, constipation, or abdominal swelling
If you think you have an emergency, call for medical help right away.
RESOURCES:
American Society for Gastrointestinal Endoscopy http://www.asge.org
CANADIAN RESOURCES:
References:
Ljungdahl M, Sundbom M. Complication rate lower after percutaneous endoscopic gastrostomy than after surgical gastrostomy: a prospective, randomized trial. Surg Endos. 2006;20(8):1248-1251.
Percutaneous endoscopic gastrostomy (PEG). American College of Gastroenterology website. Available at:
http://patients.gi.org/topics/percutaneous-endoscopic-gastrostomy-peg
Accessed December 6, 2013.
Percutaneous endoscopic gastrostomy (PEG). American Society for Gastrointestinal Endoscopy website. Available at:
http://www.asge.org/publications/publications.aspx?id=394&terms=gastrostomy
Accessed December 6, 2013.
6/2/2011 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: A systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
Last Updated: 6/23/2015