What Is a Percutaneous Endoscopic Gastrostomy?
A percutaneous endoscopic gastrostomy (PEG, or G-tube) is the least invasive way of placing food directly into the digestive tract, a process called enteral feeding. The G-tube bypasses the mouth and esophagus and directly enters the stomach through the abdominal wall.
This outpatient procedure is typically done for an individual who has a temporary inability to swallow sufficient nourishment.
How Do I Prepare for My Procedure?
In the days before your G-tube procedure, tell your physician about any medications you take, including herbal supplements and over-the-counter medications. You may be asked to stop taking aspirin or other medications that thin your blood and may increase bleeding. Tell your doctor if you or someone in your family has a history of reactions to anesthesia. Your stomach will need to be empty of food for at least 8 hours and of simple liquids for at least 2 hours prior to surgery. Ask your endoscopist if you should continue to take your regular medications with a small sip of water. Wear loose, comfortable clothing on the day of your surgery. If you are going home after the procedure, someone else must drive you home and stay with you during the early recovery period.
How Is the Procedure Performed?
At the endoscopy unit, a nurse will start an IV for sedation and medication purposes. An endoscope (a flexible tube with a camera and a light on the end) is passed through the mouth, throat, and esophagus into the stomach. Your physician then makes a small incision (cut) in the skin of the abdomen over the stomach, and the feeding tube is then guided into the stomach, and the tube is secured into position, so it can’t easily move downstream or come out too easily.
What Can I Expect After My Procedure?
Immediately following the placement of a feeding tube, you will be watched closely for any complications, such as bleeding or unexpected pain. The G-tube will be secured to your abdomen with tape. You should expect to see some slight seepage around the PEG tube for the first 24 to 48 hours. A sterile gauze dressing will be placed around the incision. Your home care nurse will teach you how to change the dressing, as needed. Once the dressing has been removed and the area has healed, be sure to wash the area daily with soap and water.
What Are the Risks Involved With the Procedure?
Possible complications include infection of the puncture site (as is the case with any type of surgery), dislodgement of the G-tube, leakage or clogging of the tube, which can usually be remedied without replacing the tube. Bleeding sometimes occurs. If the stomach doesn’t function as it should, vomiting may occur. Patients who are very frail due to underlying disorders already have an increased risk of pneumonia and heart irregularities, and any sedated surgical procedure further increases these risks.
What Are My Alternatives to This Procedure?
There are alternatives to G-tubes. A nasogastric (NG) feeding tube can be passed through the nose into the stomach for feeding and is secured to the face with tape. Long-term use of these tubes can cause nose and sinus irritation, throat discomfort, and sometimes infection. These tubes also have a tendency to be accidentally pulled out. Sometimes, however, an NG feeding tube may be preferred over a G-tube, such as if the condition being treated is expected to have an especially short duration. Similar procedures can be done to place feeding tubes into the jejunum (intestine downstream from the stomach), as well, depending on the patient’s particular situation and needs.
Where Will the PEG Be Performed?
Percutaneous endoscopic gastrostomy is performed in a hospital or outpatient surgical facility. It is not necessary to perform a G-tube placement or removal in an operating room.
How Long Does the PEG Take?
A percutaneous endoscopic gastrostomy takes just 20 to 40 minutes to complete.
Do you have more questions about G-tubes and how it may help you or a loved one? Contact the location nearest you to find out more.