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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

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 May 2018 by EBSCO Medical Review Board Marcin Chwistek, MD
Last Updated: 8/24/2018

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