What is a PEG?

PEG stands for Percutaneous (through the skin) Endoscopic (via an endoscope), Gastrostomy (to the stomach). It is a hole specially created in the stomach to allow insertion of feeding tubes through the abdominal wall directly into the stomach.

What is a PEG?

PEG stands for Percutaneous (through the skin) Endoscopic (via an endoscope), Gastrostomy (to the stomach). It is a hole specially created in the stomach to allow insertion of feeding tubes through the abdominal wall directly into the stomach.

Why have a PEG

The usual reason for PEG placement is to supplement what you currently eat or drink when you are unable to manage sufficient nutrition by mouth. It is a simple and safe way of receiving food, fluids or medications in patients who are unable to eat enough or unable to swallow safely. The decision to proceed to a PEG tube is often not easy, particularly if the decision is being made on behalf of another person. The key question you will want to answer is “Will quality of life be improved with PEG feeding?” Close discussion with family members, nursing and medical staff is often helpful.

How is a PEG tube put in?

You will be given sedation by injection to make you feel more comfortable. Antibiotics are given to reduce the risk of infection. A gastroscope is passed through your mouth into your stomach to select a suitable position to place the PEG tube. Local anaesthetic is injected into the skin of the abdominal wall and a small cut made. This cut is usually located below the ribs and slightly to the left of the midline in the upper abdomen. The PEG tube is then placed inside the stomach and will come out of your body through the cut.

What are the risks?

Minor complications occur in about 1 in 10 people. The most common are oozing from the wound, formation of granulation tissue or infection in the wound. Less common events include leakage around the tube, increased vomiting, bleeding from the wound or accidental tube dislodgement. Other rare complications include reactions to the anaesthetic/sedation (the Anaesthetist will discuss this further with you on the day of the procedure), or damage to your teeth or jaw due to the presence of instruments in your mouth (a mouth guard is inserted to protect your teeth). Serious complications are rare.

Commencing feeding through the PEG

Clear fluids, often water, will initially be given through the PEG tube 6 hours after its insertion. Once this is tolerated, then feeds and medications may be given through the tube. Your dietitian will advise on the type and quantity of feeds and full instruction and demonstration in feeding technique Depending on your condition, you are usually able to continue to eat and drink by mouth in addition to using the PEG to supplement your nutritional requirements. However, in some people where it may be unsafe to continue to eat or drink by mouth, then the PEG tube will be necessary for all feeding. Medications can also be given through the PEG tube but care is needed as some medications can clog up the tubing. Your pharmacist can advise

What care does the PEG site need after the procedure?

Bathing with mild soap can start 24 hours after the PEG tube insertion. Dry around the PEG tube site and under the bolster/T bar after bathing. Keep this site clean and dry. The PEG tube should sit snugly against the skin but not cause any deep indentations. Flush the PEG with 50ml water before and after use (or 4 times daily if not using). Rotate the tube full circle every day.

How long does the tube last?

These silicone tubes can last up to a year but will eventually need to be replaced

How long does the PEG need to remain in?

Typically, a minimum of 8 weeks before the PEG can safely be removed.

What are you responsible for?

You are less at risk of problems if you do the following:

• Follow the preparation instructions carefully.
• Bring a list of all prescribed, over the counter and herbal medication you take.
• Bring any relevant x-rays.
• Do not drink any alcohol and/or take recreational drugs 24 hours before the procedure.
• Please ensure you make arrangements for someone to drive you home after the procedure. It is not safe to drive until the following day after having sedation or an anaesthetic.

What happens after the gastroscopy + PEG insertion?

You will be admitted following for observation in addition to education and care of your PEG. You will be fasting for 6 hours following, with intravenous fluid supplementation. Following 6 hours, clear fluid diet may commence in addition to flushing the PEG with water. The following day, if all is well, return to a regular diet or PEG feeds may commence. Again, please ensure you make arrangements for someone to drive you home after discharge. Do NOT drive any type of vehicle or operate machinery for 24hours. Do NOT drink alcohol and/or take other recreational drugs. They may react with the sedation drugs. Do NOT make important decisions or sign a legal document for the first 24 hours. Notify our office on 5574 6133 during working hours or the hospital Emergency Department straight away if you have:

• severe ongoing abdominal pain.
• black tarry motions or bleeding from the back passage.
• a fever.
• sharp chest or throat pain.

Or visit our clinic at Gold Coast Private Hospital, Suite 8, Ground Floor, 14 Hill Street, Southport QLD 4215