Percutaneous Endoscopic Gastrostomy

(PEG)

Definition

Percutaneous endoscopic gastrostomy (PEG) is a procedure to place a tube through the belly wall and into the stomach.

Reasons for Procedure    TOP

A PEG gives you a different way to get nutrients. 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 a buildup of fluids

Possible Complications    TOP

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems such as:

  • Problems with the PEG tube
  • Aspiration—accidental sucking into the airways of fluid, food, or any foreign material
  • Damage to other organs
  • Inflammation of the belly lining
  • Infection
  • Bloating
  • Nausea
  • Diarrhea
  • Irritation of the skin near the tube
  • Blockage
  • An abnormal opening between 2 structures—fistula

Your chances of problems are higher for:

  • Smoking
  • Drinking
  • Chronic disease such as diabetes or obesity
  • Using certain medicines
  • Prior surgery to the area

What to Expect    TOP

Prior to Procedure

You may have:

  • A physical exam
  • Blood and urine tests
  • X-rays
  • Endoscopy—a scope is used to see internal structures

Leading up to your procedure:

  • Don't eat or drink for at least 8 hours before the procedure.
  • Arrange for a ride.
  • Talk to your doctor about the medicines you take. You may be asked to stop taking some medicines up to 1 week in advance.

Anesthesia

  • Local anesthesia—usually a lidocaine spray to numb the throat
  • Pain medicine—usually given with an IV
  • To help you relax, you may be given a sedative

Description of the Procedure    TOP

An endoscope will be inserted through your mouth and into your stomach. The camera will send images to a video monitor. This will help find the right place for the PEG tube.

A needle will be placed through the belly wall and into the stomach. A thin wire will be passed from the outside of the body, through a needle, and into the stomach. This wire will be grasped with a snare in the belly and pulled out through the mouth. There will be a thin wire from the front of the belly, 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 belly. This will pull the PEG tube down into the body.

A small cut will be made in the belly. The tube will be pulled until the tip comes out from this cut. A soft, round bumper will be attached to the ends of the PEG tube. It will keep the tube secure. Germ-free gauze will be placed around the wound. The PEG tube will be taped to the belly.

Percutaneous Endoscopic Gastrostomy Procedure

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How Long Will It Take?    TOP

30-45 minutes

Will It Hurt?    TOP

Anesthesia will prevent pain during surgery. Medicines will ease pain afterwards.

Average Hospital Stay    TOP

You may need an overnight stay. If you have problems, you may need to stay longer.

Post-procedure Care    TOP

At the Hospital

The healthcare staff will watch your breathing, heart rate, and pulse. Care may include:

  • Medicines to ease pain or stop blood clots
  • Keeping your legs elevated while in bed
  • Moving around as soon as possible

During your stay, the healthcare staff will take steps to lower your chances of infection such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to lower your chances of infection such as:

  • Washing your hands often and reminding visitors and healthcare staff to do the same
  • Reminding your healthcare staff to wear gloves or masks
  • Not allowing others to touch your incisions

At Home

You will need to:

  • Find a tube-feeding formula that works for you. A dietitian will help you.
  • Take care of the PEG tube. This includes changing the dressing, cleaning the around the site, and monitoring for infection.
  • Follow advice on exercising to help you get better faster.

Call Your Doctor    TOP

Call your doctor if any of these occur:

  • Pain that you can't control with the medicines you were given
  • The tube falls out
  • The tube isn't working as it should
  • Fever and chills
  • Redness, swelling, pain, excess bleeding, or pus from the PEG site
  • Headaches, muscle aches, lightheadedness, or general ill feeling
  • Nausea, vomiting, constipation, or swelling in the belly

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

American Gastroenterological Association
https://www.gastro.org
American Society of Colon and Rectal Surgeons
https://www.fascrs.org

CANADIAN RESOURCES:

Canadian Association of Gastroenterology
https://www.cag-acg.org
The College of Family Physicians of Canada
https://www.cfpc.ca

References:

Avitsland TL, Kristensen C, Emblem R, et al. Percutaneous endoscopic gastrostomy in children: A safe technique with major symptom relief and high parental satisfaction. J Pediatr Gastroenterol Nutr. 2006;43(5):624-628.
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:
...(Click grey area to select URL)
Accessed August 24, 2018.
Understanding percutaneous endoscopic gastrostomy (PEG). American Society for Gastrointestinal Endoscopy website. Available at: https://www.asge.org/home/for-patients/patient-information/understanding-peg. Accessed August 24, 2018.
6/2/2011 DynaMed Plus Systematic Literature Surveillance http://www.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.
Last reviewed June 2018 by EBSCO Medical Review Board Marcin Chwistek, MD
Last Updated: 8/24/2018

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