Percutaneous Endoscopic Gastrostomy (PEG) Feeding Tube & Procedure Instructions

A PEG (Percutaneous Endoscopic Gastrostomy) is a feeding tube that passes through the abdominal wall directly into the stomach, so that nutrition can be provided without swallowing or to supplement food intake. The PEG tube can be connected to a mechanical pump to provide feeds continuously, or a syringe can be used at intervals. A feeding tube is sometimes needed for patients who’ve experienced a stroke (CVA), head injury, or head or neck surgery. It may also benefit patients with cystic fibrosis, neurological diseases, such as multiple sclerosis or motor neuronal disease, or patients undergoing chemotherapy.

PEG placement involves an examination of the stomach with an endoscope. A PEG feeding tube is then passed into the stomach through a small opening on the wall of the abdomen. Attached to the tube is a small plastic disc that lies close to the skin to prevent movement of the tube and a small clamp or plastic cap that keeps the tube closed when feeding is not taking place. The procedure requires a minor operation and is usually performed in an outpatient setting with an intravenous sedative injection. Some patients, however, may require hospitalization and/or general anesthesia. After the procedure, you will feel drowsy and may have a sore throat where the endoscope has been passed. There may also be some discomfort at the incision site on your abdomen. You will be instructed on how to clean the incision site, when to start feeding after insertion of the tube, and how to administer feedings through the PEG feeding tube.

The risks of the PEG placement are similar to upper endoscopy (EGD) risks. These include the risk of bleeding, bowel perforation and adverse reaction to sedative medications. In addition, with the abdominal incision, there is a risk of accidental puncture of nearby organs, as well as infection of the skin (cellulitis). Prophylactic intravenous antibiotics will be administered with the procedure as a preventative measure for potential infection. The overall risk of a complication occurring is estimated to be 1 of 1,000 patients. Although the risk of death is extremely rare, this is also a potential complication of the procedure.

Feeding tubes can also be placed percutaneously (across the abdominal wall) either by a radiologist using X-ray guidance or by a surgeon. On occasion, if the PEG feeding tube cannot be placed safely by the endoscopic approach, the patient will be referred for one of these options.

A feeding tube can also be placed non-invasively via the nose and directed into the stomach or small intestine. Although this can be performed with minimal risk, the tube can accidentally be pulled out or fall out, and often can be uncomfortable if the tube is to remain for a prolonged period.

Note: The information in this section is provided as a supplement to information discussed with your healthcare provider. It is not intended to serve as a complete description of a particular topic or substitute for a clinic visit.