PEG Tube Placement
What is percutaneous endoscopic gastrostomy (PEG) tube?
A percutaneous endoscopic gastrostomy (PEG) tube is a feeding tube surgically placed through your abdomen into your stomach. It’s placed using a lighted flexible scope called an endoscope. The endoscope lets your surgeon to see inside your stomach as the procedure is done.
The PEG tube can stay in your stomach for months or years so you can take fluids, medicines, and nutrition through it when you can’t take in enough by mouth. Once you have this type of tube, it is important to let your doctor know if the tube comes out, because the opening will close quickly.
Why might I need a PEG tube?
A PEG tube may be a good choice for children or adults who can’t eat and drink enough to meet their daily nutrition needs. A PEG tube may also help prevent a dangerous condition called aspiration. Aspiration can occur if you have trouble swallowing normally and food or liquids enter your lungs.
Some common conditions in which a PEG tube may be recommended include:
- Birth defects
- Problems swallowing
- Cancer of the mouth or esophagus
- Diseases of the esophagus
A PEG tube may be placed if you have a long-term condition that will not allow you to swallow. To have this procedure, you must be able to digest food normally once the food reaches your stomach.
In some cases, such as a minor stroke from which you may recover, a PEG tube may be temporary. A PEG tube lasts about one year. Replacing the old tube is usually a simple procedure that your doctor can do without surgery or anesthesia.
What are the risks for a PEG tube placement?
PEG tube placement is a safe procedure, but all surgeries carry some risks. You will need to sign a consent form that explains the risks and benefits of the surgery and you should discuss these risks and benefits with your surgeon. Some potential risks of PEG tube insertion include:
- Reactions to the anesthesia
- Leakage of stomach contents around the tube
- Infection of the tube site
- Infection that spreads inside the abdomen
- Bleeding from the incision area
- Bleeding or infection from damage to other organs inside the abdomen
- Blockage or dislodging of the tube
There may be other risks, depending on your specific medical condition. Be sure to discuss any concerns with your surgeon before the procedure.
How do I prepare for a PEG tube placement?
Ask your healthcare provider to tell you what you should do before PEG tube placement. Below is a list of common steps that you may be asked to do.
- In the days before your surgery, tell your surgeon about any medicines you take, including herbal supplements and over-the-counter medications.
- You may be asked to stop taking aspirin or other medicines that thin your blood and may increase bleeding.
- Tell your doctor if you or someone in your family has any history of reaction to anesthesia.
- If you smoke, you may be asked to stop smoking well before surgery.
- On the day and night before surgery, you may be given instructions on when to stop eating and drinking.
- Ask your surgeon if you should take your regular medicines with a small sip of water.
- Wear loose, comfortable clothing on the day of surgery.
- If you are going home after surgery, arrange to have someone drive you home and stay with you during the early recovery period.
What happens during a PEG Tube placement?
Talk with your healthcare provider about what will happen during PEG tube placement. PEG tube placement is usually done under local anesthesia and sedation.
You will have an intravenous line (IV) started in your hand or arm so you can receive fluids and medications. You may be given pain medication and medication to make you sleepy through your IV. You may also be given antibiotics through your IV.
Before the procedure starts, you will need to remove any dentures. A numbing medicine may be sprayed into your throat to prevent gagging from the endoscope. A mouth guard may also be inserted. The actual procedure takes about 20 minutes. This is what usually occurs during the procedure:
- The skin over your abdomen is cleaned and a numbing medicine is injected.
- The endoscope is passed through your mouth into your stomach.
- A small surgical cut is made through your skin and into your stomach.
- The PEG tube is inserted through the opening while the surgeon watches through the endoscope.
- The tube is held in place inside your stomach with the help of a special balloon or a cap.
- A small dressing is placed at the new opening.
What happens after a PEG tube placement?
You will be taken to the recovery room to be observed while you recover from the anesthesia. You may be able to go home on the day of the procedure. Here is some of what you can expect after the procedure:
- Expect to feel some pain, such as pain at the incision and cramping or gas pain. Follow your surgeon's instructions for pain control.
- The dressing over the incision area can be removed after about 1 or 2 days.
- The incision area takes about 5 days to heal. You will be taught to clean the area daily with soap and water. After cleaning, dry the area using a small gauze pad to cover it.
- Ask your surgeon when you can start showering and bathing.
- You should be able to gradually return to normal activities, depending on your overall condition. Ask your surgeon about any activity restrictions.
- Use of the PEG tube for feeding begins gradually with clear fluids and progresses to special formula feedings.
There is a lot to learn about using and caring for a PEG tube. You will need to work closely with your medical team. The team may include doctors, nurses, pharmacists, and nutrition specialists. You will probably be told to make sure you are always upright when feeding.
Here are some of the other steps you need to learn:
- How to care for the skin around the tube
- What symptoms to look for that could mean an infection
- How to empty your stomach
- What to do if the tube gets blocked
- What formula to use and how to feed yourself
Tell your surgeon about any of the following:
- Increasing pain or pain that is not relieved by medication
- Any drainage, bleeding, redness, or swelling around the tube
- Vomiting, cramping, nausea, or diarrhea
- The tube comes out or becomes blocked
Before you agree to the test or the procedure make sure you know:
- The name of the test or procedure
- The reason you are having the test or procedure
- What results to expect and what they mean
- The risks and benefits of the test or procedure
- What the possible side effects or complications are
- When and where you are to have the test or procedure
- Who will do the test or procedure and what that person’s qualifications are
- What would happen if you did not have the test or procedure
- Any alternative tests or procedures to think about
- When and how will you get the results
- Who to call after the test or procedure if you have questions or problems
- How much will you have to pay for the test or procedure