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Percutaneous Endoscopic Gastrostomy Insertion In Children

WHAT YOU NEED TO KNOW:

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


DISCHARGE INSTRUCTIONS:

Medicines:

  • Medicines can help decrease how much acid your child's stomach makes.
  • Give your child's medicine as directed. Call your child's healthcare provider if you think the medicine is not working as expected. Tell him if your child is allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs your child takes. Include the amounts, and when, how, and why they are taken. Bring the list or the medicines in their containers to follow-up visits. Carry your child's medicine list with you in case of an emergency.

Follow up with your child's healthcare provider as directed:

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

Use your child's PEG tube as directed:

  • Check for leftover liquid food in your child's PEG tube and stomach before you start a new feeding.
  • Do not put pills into your child's PEG tube. Dissolve solid medicines in liquid before you put them in your child's PEG tube. Do not mix your child's medicines together. Give medicine one at a time.
  • Make sure you and your child know how to give feedings through his PEG tube. Ask how much formula your child should get, and how often. You may need to increase the amount of liquid food your child gets slowly until you reach the full amount.

Flush your child's PEG tube with water as directed:

The PEG tube may need to be flushed before and after each use. If your child's PEG tube is not flushed, liquid formula and medicines can block the tube. If your child's PEG tube becomes blocked, contact his healthcare provider. Do not unclog your child's PEG tube with any object, such as a wire.

Care for your child's PEG tube:

  • Check your child's PEG tube for cracks or breaks before each use. Use a medical brush to clean the tip of the PEG tube as directed.
  • Do not pull or let your child pull on his PEG tube. This can cause it to move out of place or come out. Curl the tube and tape it to his abdomen when it is not in use.
  • Change the position of the clamp on your child's PEG tube every day. This will help prevent damage to the tube.
  • Check the balloon on your child's PEG tube for leaks as directed. Check the amount of fluid by pulling the liquid out with a syringe. Ask what type of fluid to use, and add liquid back in if it has less than it should. If the balloon has lost 5 milliliters (mL) or more of liquid, the balloon may have a leak.

Care for your child's stoma:

  • You may need to change the bandage around your child's PEG tube the first morning after his procedure. The PEG tube site may take up to 4 weeks to heal. While the site heals, if it is not stitched in place, turn the PEG tube to prevent tissue from growing over it.
  • Until the stoma heals, clean the skin and stoma as directed. Wash your hands with soap and water. Change the bandages every day, or as often as your child's healthcare provider recommends. Change the bandages if they get dirty. Look for signs of infection, such as redness, swelling, or foul-smelling discharge.
  • After your child's stoma heals, wash the area every 1 to 3 days or if it is dirty. Remove your child's bandage and wash the area with soap and water. Gently dry the area and put on a new bandage around your child's PEG tube.

Care for your child:

  • Cap your child's PEG tube when it is not in use. Uncap the PEG tube if your child complains of gas pain or nausea. This will help release gas buildup and may relieve his symptoms.
  • Arrange your child's feeding schedule to make sure he gets enough sleep. Tell your child's healthcare provider if the PEG tube makes it hard for him to sleep.
  • Have your child carry pads or absorbent cloths with him in case his PEG tube leaks. You may also want to make sure he has a change of clothing.

Contact your child's healthcare provider if:

  • Your child has a fever.
  • You think your child's PEG tube balloon has a leak.
  • The skin around your child's PEG tube breaks open, skin grows over his tube, or his stoma gets larger.
  • You cannot move your child's PEG tube, the tube comes out, or the tube cracks or breaks.
  • Your child's PEG tube moves in or out of his stoma more than 1 centimeter.
  • Your child's PEG tube is leaking, or liquid will not enter the tube and spills out.
  • Your child has nausea or diarrhea, is vomiting, or cannot have a bowel movement.
  • You have questions or concerns about your child's condition or care.

Seek care immediately or call 911 if:

  • Your child has sudden trouble breathing.
  • The skin around your child's PEG tube is warm, swollen, red, or has pus coming from it.
  • Your child has diarrhea leaking around his tube.
  • Your child's bowel movements look like the liquid food he uses.
  • Your child has increased stoma drainage, or his stoma is bleeding and will not stop.
  • Your child vomits blood, or his bowel movements are bloody or black.
  • Your child's stoma or the skin around it is red, swollen, and has blisters.
  • Your child's stomach becomes tight, hard, sore, or swollen.

© 2015 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.

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