Associates in Digestive Diseases

Percutaneous Endoscopic Gastrostomy (PEG)

Percutaneous Endoscopic Gastrostomy or PEG is a technique used to place a flexible tube into the stomach where it can be used for feeding, medication administration or drainage. The tube enters into the abdominal wall, directly into the stomach.

When Used
This technique is employed when a patient has difficulty swallowing, cannot take adequate caloric intake orally, or, in the case of a gastric blockage, may be used to drain gastric contents.

The Procedure
The procedure is done in a similar fashion to an upper endoscopy.

Complications
While complication are rare, they include local infection, bleeding, perforation, leakage around tube, aspiration and any complication associated with sedation.

Care and Usage
After the tube is in place, a sterile dressing is placed around the new opening. The patient is given instructions on care and dressing changes. After the initial period, the area must be kept clean and dry but no dressing will be needed.

Replacement
In the event that the tube falls out, or is clogged or worn out, it will need to be replaced. Often the new tube can be replaced in the outpatient setting without requiring a repeat endoscopy. Sometimes circumstances will require repeat endoscopy for safe and accurate placement. If it does fall out, prompt notification is critical which may allow the doctor to replace the tube simply without endoscopic intervention.

Eating with a PEG
Most often a PEG is placed in a situation where oral nutrition is either inadequate or unsafe. If the swallowing mechanism is intact and a gag reflex is functional, then tube or pump feedings can be supplemented with oral feedings.

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