What Is PEG?
The PEG refers to percutaneous endoscopic gastrostomy. The PEG is defined as accessing the stomach with an endoscope and placing a flexible feeding tube in the stomach through anterior abdominal wall for nourishment.
With the use of this tube, foods and fluids can be directly delivered to stomach by bypassing the mouth and esophagus. This leaflet will provide information with you in detail about the procedure; for instance, how it's performed, how it can help, and what side effects you might experience. Of course, you may not find answers for some of your questions, as each patient
has a different medical needs and attention. In this case, we advise you to ask your unanswered questions to your physician.
How Is PEG procedure performed?
Using a flexible device with light and camera on the tip, called the endoscope, your physician creates an opening that will connect your stomach and skin of anterior abdominal wall. Afterwards, a tube is placed in stomach and secured at this site. Patients generally receive an intravenous sedative and local anesthesia, and an antibiotic is given by vein prior to the procedure. Depending overall condition, consciousness and additional diseases of patients, the procedure can be performed under operating room conditions and general anesthesia. Patients can usually go home the day of the procedure or the next day.
Who can benefit from the PEG procedure?
This procedure is recommended for those who suffer dysphagia (swallowing difficulty), loss of appetite and malnutrition. Some severe complications may arise in the long-term intravenous nutrition or the nutrition with tubes inserted through the nose into the stomach. In cases when gastrointestinal tract is functional, the healthiest long-term nutritional method is to put the foods directly into stomach of small intestines. However, PEG is not recommended if oral intake is possible after a short period of time or life expectancy is quite short.
What kind of care does the PEG tube require?
A medical dressing is placed on the PEG site following the procedure. This dressing is usually removed after one or two days. After that you should clean the site once a day with diluted soap and water and keep the site dry between cleansings. No special dressing or covering is needed.
How are feedings given? Can I still eat and drink?
Specialized liquid nutrition, as well as fluids, are given through the PEG tube using a large syringe, plastic tube bags functioning by gravity or tube systems connected with a mechanical pump. You will be provided with hands-on training by your physician or a healthcare professional. Although the PEG procedure does no prevent you from eating or drinking, this is a very important issue to discuss with your physician.
Are there complications from PEG placement?
Complications can occur with the PEG placement. Possible complications include pain at the PEG site, leakage of stomach contents around the tube site, and dislodgment or malfunction of the tube as well as infection of the PEG site, aspiration (inhalation of gastric contents into the lungs), bleeding and perforation (an unwanted hole in the bowel wall). If the PEG is unintentionally dislodged at the early period following placement, leakage of the gastric contents in the abdomen may occur. Your doctor will describe the symptoms that could indicate a possible complication.
How long do these tubes last? How is the PEG tube removed?
PEG tubes can last for months or years. However, it should be noted that they might need to be replaced, because they can break down or become clogged with residual formula over extended periods of time. Your physician can easily remove or replace the tube without sedatives or anesthesia, but your doctor might prefer use sedation and endoscopy in some cases. When a replacement or removal is needed, your physician removes the tube using firm traction and either inserts a new tube or let the opening close spontaneously if no replacement is planned. Once the tube is involuntarily removed, PEG sites close quickly. Therefore, it is very important for you to immediately consult your physician or apply to a hospital if an accidental dislodgment occurs. Otherwise, endoscopy-guided PEG placement may be considered.