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Percutaneous Endoscopic Gastrostomy (PEG) Tube Feeding                            


What is percutaneous endoscopic gastrostomy (PEG)?
  • Percutaneous endoscopic gastrostomy (PEG) is a surgical procedure for placing a feeding tube without having to perform an open operation on the abdomen (laparotomy). A gastrostomy (a surgical opening into the stomach) is made percutaneously (through the skin) using an endoscope (a flexible, lighted instrument) to determine where to place the feeding tube in the stomach and secure it in place.

Picture of PEG Tube Feeding

What is the purpose of PEG?
  • The aim of PEG is to feed those who cannot swallow. Irrespective of the age of the patient or their medical condition, the purpose of PEG is to provide fluids and nutrition safely and directly into the stomach, to significantly increase the quality of life, maintaining appropriate weight levels and nutritional requirements.

Who does PEG?
  • PEG is done by a doctor. The doctor may be a general surgeon, an otolaryngologist (ENT specialist), a gastroenterologist (GI specialist), etc.


Where is PEG done?
  • PEP is performed in a hospital or outpatient surgical facility.

How is PEG done?
  • PEG tubes are placed with the aid of an endoscope (a flexible, lighted instrument), the scope going down the throat (with local anesthesia to the throat) to assist in guiding the placement of the tube through the wall of the stomach. The surgery is simple and involves little risk or discomfort. The procedure takes about 20 minutes. The doctor then makes a small incision (cut) in the skin of the abdomen and pushes an intravenous cannula (an IV tube) through the skin into the stomach and sutures (ties) it in place. The PEG tube extends from the interior of the stomach to outside the body through a small incision only slightly larger than the tube itself in the abdominal wall. The tube is prevented from coming out of the stomach by one of several methods. Some brands have a small wire within the tube, which after insertion is pulled from the exterior end of the tubing causing the portion within the stomach to curl up or “pigtail,” preventing it from being pulled out. Other systems employ a very small balloon at the end of the tube which is inflated within the stomach after insertion, serving the same purpose. Removal of the tube simple involves cutting the wire which created the pigtail, or deflating the balloon section of the tube allowing it to slip easily from the stomach. About three inches of tubing will protrude from the incision area. Initially, there may be some discomfort while getting used to using the system, from gas or air, or from adjusting to the liquid foods themselves.


When can the PEG patient go home?
  • The patient can usually go home the same day or the next morning.

What are the possible complications with PEG?
  • Possible complications include wound infection (as in any kind of surgery) and dislodging or malfunction of the tube.
  • The likelihood of complilcations may occur but is slight, with only a one percent chance of major problems (gastric hemorrhage, peristomal leakage) and an eight percent chance of minor ones (infection, stomal leaks, tube extrusion or migration, aspiration and fistula formation). Aspiration is perhaps the most common complication related to tube feeding. This occurs when food is actually inhaled into the lungs. Aspiration can lead to pneumonia, but if the patient is kept upright during feeding, the likelihood of developing this complication can be greatly minimized.

Major complications include:
  • Aspiration pneumonia
  • Gastric perforation
  • Gastrocolic fistula  
  • Internal leakage
  • Dehiscence
  • Peritonitis
  • Subcutaneous abscess
  • Buried bumper syndrome (migration of the internal bumper of the PEG tube into the gastric or abdominal wall).

Minor complications include:

  • Tube problems:
    • Tube blockages
    • Tube dislodgements
    • Tube degradation
    • External leakage
    • Unplanned removal  
  • Site infections (common but rarely serious.12 There have been studies to determine whether prophylactic antibiotics prevent such infections.  

Call Your Doctor If Any of the Following Occurs

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
  • Headaches, muscle aches, dizziness, fever, or general ill feeling
  • Nausea, constipation, or abdominal swelling
  • Vomiting



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