Percutaneous endoscopic gastrostomy (PEG) tube placement is a procedure used to place a feeding tube directly into the stomach through the abdominal wall. The tube provides a safe and effective way to deliver nutrition, fluids, and medications when a person is unable to eat or drink adequately by mouth.
The procedure is performed using an endoscope, a long, thin, flexible tube with a light and camera, which allows the physician to visualize the stomach and guide placement of the feeding tube.
PEG tubes are commonly used for patients who require long-term nutritional support due to swallowing difficulties, neurological disorders, cancer, or other conditions that interfere with normal eating.
Reasons for PEG tube placement
Your physician may recommend PEG tube placement for the following reasons:
- Difficulty swallowing (dysphagia)
- Stroke-related swallowing disorders
- Neurological conditions affecting swallowing
- Head and neck cancers
- Esophageal disorders
- Severe malnutrition
- Inability to maintain adequate oral nutrition
- Chronic aspiration risk
- Need for long-term enteral (tube) feeding
- Certain gastrointestinal disorders requiring nutritional support
Reasons for tube replacement or exchange
A PEG tube may need to be replaced or exchanged for the following reasons:
- Routine tube maintenance
- Tube malfunction or blockage
- Tube damage or deterioration
- Accidental tube dislodgement
- Leakage around the tube site
- Infection requiring tube replacement
- Conversion to a different feeding device
Benefits of PEG tube placement
PEG tube placement provides a reliable method for long-term nutritional support. Benefits include:
- Improved nutritional intake
- Maintenance of hydration
- Safe administration of medications
- Reduced risk of aspiration from oral feeding in selected patients
- Long-term feeding access
- Improved quality of life for patients unable to eat adequately
- A minimally invasive alternative to surgical feeding-tube placement
How to prepare
Please inform your healthcare team if you have heart disease, lung disease, diabetes, bleeding disorders, previous abdominal surgery, allergies to medications, or any other significant medical condition.
- Do not eat or drink anything for at least 8 hours before the procedure.
- Inform your physician of all medications you are taking.
- Follow instructions regarding blood thinners, antiplatelet medications, insulin, and diabetic medications.
- Arrange for a responsible adult to accompany you home if the procedure is performed on an outpatient basis.
What to expect during the procedure
- An intravenous (IV) line will be started.
- Medications will be administered to help you relax and remain comfortable.
- You will wear a hospital gown.
- The physician will perform an upper endoscopy to visualize the stomach.
- A small area of the abdomen will be cleaned and prepared using sterile technique.
- A small incision is made in the abdominal wall.
- The PEG tube is guided into the stomach and secured in place.
- The position of the tube is confirmed before the procedure is completed.
- The procedure generally takes approximately 20 to 45 minutes.
After the procedure
- You will remain in the recovery area for observation until the effects of sedation begin to wear off.
- Mild soreness around the tube site is common for several days.
- The healthcare team will provide instructions on tube care and feeding schedules.
- Feeding through the tube is typically started according to your physician's recommendations.
- You and your caregivers will receive education on proper PEG tube management.
Caring for your PEG tube at home
- Wash your hands before handling the tube.
- Keep the tube site clean and dry, and clean the skin around it daily.
- Flush the tube before and after feedings and medications as instructed to prevent clogging.
- Use only prescribed formulas and medications.
- Avoid pulling or placing excessive tension on the tube.
- Inspect the tube site daily for signs of infection, and report any changes in tube function or appearance.
Contact your physician if you experience
- Fever or chills
- Increasing redness or swelling around the tube site
- Drainage or pus from the insertion site
- Severe abdominal pain
- Persistent nausea or vomiting
- Leakage around the tube
- Tube blockage or dislodgement
Risks and possible complications
PEG tube placement is generally safe when performed by experienced physicians, and most patients tolerate the procedure well. Possible complications include:
- Pain or discomfort at the insertion site
- Bleeding
- Infection of the tube site
- Leakage around the tube
- Tube blockage
- Tube dislodgement
- Aspiration
- Injury to nearby organs
- Perforation of the stomach or intestine
- Adverse reactions to sedation medications
Although serious complications are uncommon, they may require hospitalization, additional procedures, or surgery. With proper care, a PEG tube can provide safe and effective nutritional support for months or years, depending on your medical needs.