PEG is a non-surgical technique for percutaneous placement of a feeding gastrostomy tube using an endoscope. This procedure is performed to a person having dificulty in swallowing or cannot consume enough food by mouth. During this procedure, a gastrostomy tube is placed in the stomach to directly feed to the GI tract.

Basically, the only preparation is nothing to eat or drink anything after midnight. Inform your physician if you are on anticoagulant therapy.

You will be given a sedative and an antibiotic intravenously. The physician will insert an endoscope through your mouth and into the stomach. Through the endoscope, the physician will choose the site where PEG tube will be inserted. A local anesthetic is injected at the site, a small incision is made in the abdominal wall, and the feeding tube is inserted. The procedure takes approximately 20 to 30 minutes.

A sterile gauze dressing with an antibiotic ointment will be placed around the incision and the PEG tube will be secured to your abdomen with tape. You will be started on enteral feeding (feeding throught the feeding tube). If you are having difficulty or have any questions, contact your physician.

Proper nutrition and diet are important in helping to prevent many diseases and to support development, growth, and healing. A PEG tube provides access to the stomach if long term nutiritional support is necessary. Follow instructions below for feeding procedure.

Supplied needed

• Feeding syringe (60 cc catheter tip syringe).
• Water.
• A can of liquid feeding /formula such as Ensure (250cc).
• Clamp.
• Towel.

Feeding

• Wash your hands with soap and water.
• Identify the port of feeding tube (some feeding tubes may have an additional balloon inflation port).
• Elevate the head and torso 30 to 45 degrees.
• Verify that the g-tube is inside of the stomach by inserting a catheter tip syring filled with 10 to 15 cc air into the feeding port. Place your ear on the abdomen and listen for air sounds as you depress the syringe plunger to inject air into the tube to the stomach or, by aspirating gastric contents.
• Use the catheter tip syringe to flush the G-tube with 20cc of water.
• Using the catheter tip syringe, remove the pluger and pour formula into the syringe. As the formula runs in, more formula is poured into the syringe until the formula is finished. Increase or decrease the flow rate by raising or lowering the syringe.
• After feeding, flush the G-tube with 20 cc of water.
• Disconnect the syringe and close the feeding port.

Always flush your G-tube before and after feeding to avoid blockage or obstruction of the tube. To de-clog an obstructed tube, fill a cathere tip syring with warm water and inject the water gently into the tube. Repeat until the blockage clears. If the blockage does not clear, the tube may need to be replaced. Do not attempt to insert any objects such as Q-tips inside the tube.

To ensure a healthy gastrostomy site, keep the skin clean and dry. Wash the area with soap and water. Rotate the feeding tube every day to prevent the turbe from adhering to the stoma. Dry the skin surface well after tube care.

You will need to observe the site for any complications such as an infection (redness, swelling, pus like discharge around the site).

• The tube comes out.
• You are having difficulty during feeding.
• You have a bloody or pus like discharge around the tube.