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Peg Tube Insertion

AMBULATORY CARE:

What you need to know about percutaneous endoscopic gastrostomy (PEG) tube insertion:

PEG insertion is a procedure to place a soft, plastic feeding tube into your stomach. You may get nutrition or medicine through the tube. The tube may also be used to remove air and fluid from your stomach.

How to prepare for the procedure:

  • Your healthcare provider will talk to you about how to prepare for your procedure. He or she may tell you not to eat or drink anything after midnight on the day of your procedure.
  • Tell your provider about all the medicines you currently take. He or she will tell you if you need to stop any medicine before the procedure, and when to stop. He or she will tell you which medicines to take or not take on the day of your procedure.
  • Arrange to have someone drive you home after the procedure and stay with you.

What will happen during the procedure:

  • You will be given medicine to help you relax and make you drowsy. Your healthcare provider will insert an endoscope through your mouth, down your esophagus, and into your stomach. An endoscope is a bendable tube with a light on the end. The light will help your healthcare provider find the best place to insert the PEG tube. Air may be injected into your stomach so your provider can see clearly.
  • Your provider will make a small incision in your abdomen and insert a catheter with a wire through the opening and into your stomach. He or she 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. If your healthcare provider cannot use an endoscope, he or she will place the PEG tube directly into your stomach through the incision on your abdomen. He or she will use an ultrasound to find the right place to put the PEG tube in your stomach.
  • Your provider will bring one end of the PEG tube out through the opening in your abdomen. The opening is called a stoma. The other end of the PEG will stay in your stomach. The end will be held in place with a piece of plastic or small inflated balloon. This will prevent it from coming out through the stoma.

What to expect after the 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 may then be able to go home.

  • The tube will be taped to your abdomen. The area will be covered to keep it clean and prevent infection. You may see drainage for a few days.
  • The area where the tube was placed may be sore or tender. This is normal and should get better in a day or two.

Risks of PEG tube insertion:

  • 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.

Call your local emergency number (911 in the US) for any of the following:

  • You have sudden trouble breathing.
  • Your heart is beating much faster than usual.

Call your doctor or gastroenterologist if:

  • You vomit blood, or your bowel movements are bloody or black.
  • You have sudden abdominal pain and dizziness.
  • You have increased stoma drainage, or your stoma is bleeding.
  • The skin around your stoma is bright red, swollen, and has blisters.
  • The skin around your stoma breaks down, skin grows over your tube, or your stoma gets larger.
  • Your stomach becomes tight, hard, sore, or swollen.
  • You have diarrhea leaking around your tube.
  • Your bowel movements look like the liquid food you use.
  • You have a fever.
  • Your PEG tube feels tight against your skin.
  • You have leakage around your PEG tube, or your formula will not enter the tube and spills out.
  • You cannot move your PEG tube, the tube comes out, or the tube cracks or breaks.
  • You have nausea or are vomiting, or you cannot have a bowel movement.
  • You have questions or concerns about your condition or care.

Medicines:

  • Medicines can help decrease how much acid your stomach makes.
  • Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Self-care:

  • Change the bandage around your PEG tube the morning after your procedure, as directed. The PEG tube site may take up to 4 weeks to heal. While the site heals, turn the PEG tube to prevent tissue from growing over it.
  • Prevent an infection. Always wash your hands before you care for the area around your PEG tube. Use soap and running water. Dry your hands with a clean towel or a paper towel. Anyone caring for your PEG tube should wash his or her hands first.
    Handwashing
  • Arrange your feeding schedule. Time your feedings to make sure you get enough sleep. Tell your healthcare provider if the PEG tube makes it hard for you to sleep.
  • Carry pads or absorbent cloths with you in case your PEG tube leaks. You may also want to bring a change of clothing.

Follow up with your doctor or gastroenterologist as directed:

Write down your questions so you remember to ask them during your visits.

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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.

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