Percutaneous Endoscopic Gastrostomy Insertion

What you should know

Percutaneous endoscopic gastrostomy (PEG) insertion is a procedure to place a soft, plastic feeding tube into your stomach. You may need a PEG tube if you cannot get enough nutrition eating your food. Liquid food can be given through the tube to give your body the nutrition it needs. The tube may also be used to remove air and fluid from your stomach.


Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

  • The endoscope may cause damage or bleeding in your esophagus, stomach, or abdomen. During or after the procedure, liquid from your stomach may get into your lungs and cause an infection. Your stoma and skin around it may be bruised and painful. Sores may form in the skin around your stoma, and tissue may grow over the PEG tube.

  • The end of the PEG tube in your stomach may move out of place. Your PEG tube may become blocked and it may crack, break, or leak. Your stomach may not empty into your intestines correctly. A fistula (abnormal tissue opening) may form between your skin and stomach or intestines. Your stoma may become infected. The infection may spread to other areas of your body and become life-threatening.

Getting Ready

The week before your procedure:

  • Write down the correct date, time, and location of your procedure.

  • Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.

  • Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.

  • You may need blood tests before your procedure. Talk to your healthcare provider about these or other tests you may need. Write down the date, time, and location for each test.

  • Ask about supplies you may need to care for your PEG tube at home.

The night before your procedure:

Ask caregivers about directions for eating and drinking.

The day of your procedure:

  • Ask your caregiver before taking any medicine on the day of your procedure. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring a list of all the medicines you take, or your pill bottles, with you to the hospital.

  • You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

  • Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.

  • Local anesthesia is a shot of medicine put into your abdomen. It is used to numb the area and dull the pain. You may still feel pressure or pushing during the procedure. You will also be given medicine in your IV to keep you calm and relaxed.

Treatment

What will happen:

  • Your healthcare provider will insert the endoscope through your mouth, down your esophagus, and into your stomach. The light on the end of the endoscope may be seen through your abdomen. The light will help your healthcare provider find the best place to insert the PEG tube. He may inject air into your stomach so he can see clearly.

  • Your healthcare provider will make a small incision in your abdomen and insert a catheter with a wire through the opening and into your stomach. He will guide the wire up through the endoscope and into your mouth. The PEG tube will be attached to the wire and pulled down into your stomach. Your healthcare provider will bring one end of the PEG tube out through the opening in your abdomen. The other end of the PEG will stay in your stomach and will be held in place with a piece of plastic or small inflated balloon. This will prevent it from coming out through the opening in your abdomen (stoma).

  • Once the PEG tube is in the right place, the endoscope and wire will be removed. If your healthcare provider cannot use an endoscope, he will place the PEG tube directly into your stomach through the incision on your abdomen. He will use an ultrasound to find the right place to put the PEG tube in your stomach.

After your procedure:

You will be taken to a room to rest until you are fully awake. You will be monitored closely for any problems. Do not get out of bed until your healthcare provider says it is okay. You will then be able to go home or be taken to your hospital room.

Contact a caregiver if

  • You cannot make it to your procedure.

  • You have a fever.

  • You get a cold or the flu.

  • You have questions or concerns about your procedure.

Seek Care Immediately if

  • You have new trouble breathing.

  • You have severe stomach pains.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Percutaneous Endoscopic Gastrostomy Insertion (Precare)

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