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Percutaneous Endoscopic Gastrostomy
WHAT YOU SHOULD KNOW:
- Percutaneous endoscopic gastrostomy (PEG) 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 food by mouth. Without enough nutrition, you may lose too much weight and become dehydrated (loss of body fluids). Formula (liquid food) can be given through the tube to give your body the nutrition it needs. The tube may also be used for decompressing (removing air and fluid) your stomach. Your caregiver uses an incision (cut) and an endoscope to insert the PEG tube into your stomach. An endoscope is a small, bendable tube with a light and camera on its tip. One end of the PEG tube is inside your stomach, and the other end is secured on your abdomen. Your abdomen is a cavity (space) that holds many organs, such as your stomach, intestines (bowels), and liver.
- You may have trouble eating if you have cancer in your mouth or esophagus (food pipe). Medical conditions, such as a stroke or other brain and nerve problems, may cause trouble swallowing. You may also have trouble swallowing from an injury or a serious (very bad) burn. You may need a PEG tube for decompression if your stomach does not empty on its own. You may need your PEG tube for a short time, or for the rest of your life. A PEG tube used for decompression may stop nausea (upset stomach) and vomiting (throwing up). A PEG tube may prevent loss of body weight and dehydration. A PEG tube may allow your body to get the nutrition it needs to function.
Take your medicine as directed.
Call your primary healthcare provider if you think your medicine is not helping or if you have side effects. Tell him 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.
- Antiulcer medicine: This medicine helps decrease the amount of acid that is normally made by the stomach.
Ask for information about where and when to go for follow-up visits:
For continuing care, treatments, or home services, ask for more information.
- You may need to see a speech therapist if your PEG tube is temporary. A speech therapist may do tests to check how well you are swallowing. If your swallowing improves, and you can eat enough food, your PEG tube may be removed.
Using your percutaneous endoscopic gastrostomy tube:
- A medical company may provide your formula and feeding supplies. Ask your caregiver how to contact the right supply company for you.
- Check for residual (left-over) formula in your PEG tube and stomach before starting a new feeding. Ask your caregiver how to check for residuals.
- Do not put pills into your PEG tube. Dissolve non-liquid medicines in liquid before putting them in your PEG tube. Ask your caregiver to show you how to dissolve non-liquid medicines.
- Make sure you or a family member know how to give feedings through your PEG tube correctly. Ask your caregiver's how much formula you should get, and how often. Also, ask your caregiver how much time each feeding should take. You may need to increase the amount of formula you get with each feeding. You will increase the amount of formula you get until you reach the right amount for your body. A nutrition caregiver may help you learn the right amount of formula to give yourself.
Flushing your percutaneous endoscopic gastrostomy tube:
Flush your PEG tube with water or other liquid as directed by your caregiver. You may need to flush your PEG tube before and after each use. If your tube is not flushed, liquid formula and medicines can dry up and block the PEG tube. Ask your caregiver how to flush your PEG tube and when you should flush it.
Caring for your percutaneous endoscopic gastrostomy tube:
- Check your PEG tube for cracks or breaks before each use.
- Do not pull, or allow anything to pull on your PEG tube. Pulling can cause your PEG tube to move out of place or come out. Pulling your PEG tube may also injure your stoma area. To prevent pulling, curl the tubing and tape it to your abdomen when you are not using it. Ask your caregiver to show you the best way to curl and tape your PEG tube.
- Make sure you can move your PEG tube in and out of your stoma about one centimeter. If you gain weight, and your PEG tube feels tight against your skin, the tube may need to be changed.
- Use a special brush to clean the tip of your PEG tube as directed by your caregiver.
Caring for your stoma:
- You may need to change the bandage around your PEG tube the first morning after your procedure. The PEG tube site may take up to 1 to 4 weeks to heal. While the site heals, rotate (turn) the PEG tube to prevent tissue from growing over it. Ask your caregiver how to clean your skin and PEG tube site while it heals.
- After your stoma heals, wash the area every 1 to 3 days as needed. Remove your drain bandage when washing around the stoma. Wash the area with soap and water. Do not use perfumed soaps, as they may contain alcohol that can dry your skin. Once the area is clean and dry, put a new, dry drain bandage around your PEG tube. Make sure the bandage is not tight against your skin so air can pass under it. Talk with your caregiver if you have questions about how to care for your stoma.
Decompressing your stomach:
Your PEG tube may be capped when you are not using it. If you feel gas pains, decompress your stomach by uncapping the PEG tube to release the gas. You may also uncap your PEG tube for decompression if you have nausea. Ask your caregiver when you should cap and uncap your PEG tube.
Living with a percutaneous endoscopic gastrostomy tube:
Having a PEG tube may be life-changing for you and your family. You may feel angry, sad, or worried about the PEG tube, and what others may think of it. These feelings are normal. Talk with your caregivers, family, or friends about your feelings. The following tips may help make living with a PEG tube easier:
- Arrange your feeding schedule to make sure you get enough sleep. Tell your caregiver if the PEG tube makes it hard for you to sleep.
- Prepare ahead of time before leaving your home to help you feel more comfortable. Make sure you carry absorbent cloths or pads with you in case your PEG tube leaks. You may also want to bring a change of clothing. Find out in advance where you can feed privately when you are in public places.
Do not drink alcohol because it can make your illness worse and delay healing. Alcohol includes beer, wine, and liquor, such as vodka and rum. Drinking a lot of alcohol can damage your brain, heart, and liver. The risk for high blood pressure, stroke, and certain types of cancer are greater for people who drink too much alcohol. Tell your caregiver if you drink alcohol. If you drink alcohol, talk with your caregiver if you need help to stop.
Manage your diabetes:
If you have diabetes, it is important to manage your blood sugar levels. High blood sugar levels increase your risk for infection and skin sores around your PEG tube.
CONTACT A CAREGIVER IF:
- The skin around your stoma breaks down, skin grows over your tube, or your stoma gets larger.
- You cannot move your PEG tube, the tube comes out, or the tube cracks or breaks.
- You have a fever.
- You have leakage around your PEG tube, or your formula will not enter the tube and spills out.
- You have nausea, vomiting, diarrhea, or you are unable to have a bowel movement (BM).
- Your skin becomes itchy, swollen, or you get a rash.
- You have questions or concerns about your procedure or care.
SEEK CARE IMMEDIATELY IF:
- The skin around your PEG tube is warm, swollen, red, or has pus coming from it.
- You have diarrhea leaking around your tube, or your BMs look like the formula you are using.
- You have increased stoma drainage, or your stoma is bleeding and will not stop.
- You have sudden trouble breathing or your heart is beating much faster than normal for you.
- You vomit blood, see blood in your BMs, or your BMs look like black tar.
- You have sudden abdominal pain and dizziness.
- Your stoma, or the skin around it, is bright red, swollen, and has blisters.
- Your stomach becomes tight, hard, sore, or swollen.
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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.