Percutaneous Endoscopic Gastrostomy (PEG)

A PEG insertion is a procedure beneficial for patients who have long-term nutritional requirements and cannot take food by mouth. A flexible feeding tube is inserted through the abdominal wall and into the stomach. This allows liquid nutrition products and medications to be put directly into the stomach, bypassing the esophagus. The tube may be temporary or permanent depending on the patient’s condition. The procedure is performed at Forsyth Medical Center by our physicians.

How is the PEG performed?

Your doctor will use a lighted flexible tube called an endoscope to guide the creation of a small opening through the skin of the abdomen and directly into the stomach. This procedure allows the doctor to place and secure a feeding tube into the stomach. Patients generally receive a mild sedative and local anesthesia, and an antibiotic is given by vein prior to the procedure. Patients can usually go home the day of the procedure or the next day.

Who can benefit from a PEG?

Patients who have difficulty swallowing, problems with their appetite or an inability to take enough nutrition through the mouth can benefit from this procedure.

How should I care for the PEG tube?

A dressing will be 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; keep the site dry between cleansings. No special dressing or covering is needed.

How are feedings given? Can I still eat and drink?

Liquid nutritional supplements are given through the PEG tube using a large syringe, a gravity drip via a tube connected to a hanging plastic bag, or a mechanical pump. Your doctor or other health care provider will give you complete instructions and a demonstration. A PEG does not prevent a patient from eating or drinking, but your doctor and you might decide to limit eating or drinking depending on any associated medical conditions.

Are there complications from PEG placement?

Complications can occur with the PEG placement including pain at the PEG site, leakage of stomach contents around the tube site, and dislodgment or malfunction of the tube. Possible complications include infection of the PEG site, aspiration (inhalation of gastric contents into the lungs), bleeding and perforation (an unwanted hole in the bowel wall). Your doctor can describe for you symptoms that could indicate a possible complication.

 How long do these tubes last? How are they removed?

PEG tubes can last for months or years. However, because they can break down or become clogged over extended periods of time, they might need to be replaced. Your doctor can easily remove or replace a tube without sedatives or anesthesia, although your doctor might opt to use sedation and endoscopy in some cases. Your doctor will pull out the tube using firm traction and will either insert a new tube or let the opening close if no replacement is needed. PEG sites close quickly once the tube is removed, so accidental dislodgment requires immediate attention.