Percutaneous Endoscopic Gastrostomy (PEG) tube
What is a PEG tube?
It is a soft, plastic feeding tube. It goes into your stomach. Liquid, such as formula, fluids, and medicines can be put through the PEG tube if you cannot eat or drink all the nutrients you need. It can also be used to take air and fluid out of your stomach.
How do I get a PEG tube?
You go to the Digestive Health Center to get a PEG tube placed. A tool called an endoscope (scope) is used. It is a small camera with a light on a thin, flexible tube. It goes down into your mouth, through your esophagus (food pipe), and into your stomach. The light helps your doctor find the best place to put the PEG tube.
Your care team will start an intravenous (IV) catheter. They will give you medicine through the IV to help you relax. Your doctor will also give you local anesthesia. This is a shot of medicine in your skin to numb the site where the cut is made. These keep you from having pain while getting the PEG tube.
Your doctor will make a small incision (cut in your skin). Then, they put the PEG tube in an opening in your stomach. This is called a stoma. A small balloon is blown up on the end of the PEG tube inside your stomach and a small disc is on the outside to hold it in place.
What are the risks of getting a PEG tube?
- Damage or bleeding in your esophagus and stomach from the scope
- Lung infection due to liquid in your stomach getting into your lungs
- Bruising, pain, and sores around your stoma
- An infected stoma
- The end of the PEG tube moving out of place
- The PEG tube can get blocked, crack, break, and leak
Will it hurt getting a PEG tube?
You will be given medicines in an IV to help you relax. These will make you sleepy. You may not feel pain or remember the procedure. You may feel pressure or pushing during the procedure.
You may have a little pain after it is in. Take mild pain medicine to help.
How do I get ready for the PEG tube procedure?
Your medicines may need to stop or change before your PEG tube is put in. Call the doctor who ordered your medicines at least 2 weeks before your procedure.
Blood thinners: Call the doctor that orders your medicines, such as Coumadin® (warfarin), Plavix® (clopidogrel), Ticlid® (ticlopidine hydrochloride), Agrylin® (anagrelide), Xarelto® (rivaroxaban), Pradaxa® (dabigatran), and Effient® (prasugrel).
Insulin or diabetes pills: Call the doctor that watches your sugar levels. Your doses may need to change because of the diet needed. Bring them with you on the day of your procedure.
Give your care team a list of your medicines and doses. Tell your care team if you use any herbs, food supplements, or over-the-counter medicine. Tell your care team if you have any allergies.
1 day before your procedure
- You may eat and drink as normal.
- Do not drink alcohol the day before or day of your procedure.
- Do not eat or drink after midnight the night before your morning procedure. If your procedure is in the afternoon, you may drink clear liquids up to 2 hours before your check-in time.
The day of your procedure
Your care team will ask you to sign a legal paper called a consent form. It will tell you about the procedure and the risks. Signing the form gives your doctor permission to place your PEG tube. Make sure all your questions are answered before you sign the form.
After your procedure
You stay in a recovery room until you are fully awake. Then you will go home or to your hospital room. It is normal to have a sore throat for 2 to 3 days.
When should I call my doctor?
Call your doctor if:
- The skin around your PEG tube is red, hot, hurts to touch, or has greenish-yellow drainage
- You have a fever
- The tube feels tight around your skin
- The skin around your PEG tube breaks down
- Skin grows over your tube
- Your stoma (the opening in your skin) gets bigger
- You have a lot of leaking around your tube (some leaking is normal)
- Your tube gets blocked
- Your tube is cracked or breaks
- Your tube comes out
- You have any questions or concerns
Call your primary care doctor if:
- You have nausea (feel like you are going to throw up) or vomiting (throwing up)
- You cannot have a bowel movement
How do I take care of a PEG tube?
- It may take 4 to 6 weeks for the skin around the PEG tube to heal.
- Clean the skin around your PEG tube each day or if it is dirty with mild soap and water. Try to gently remove any drainage or crusting on the skin or tube. Let your skin dry all the way under the disc.
- Do not place gauze between the disc and skin.
- Do not use any ointments, powders, or sprays around the PEG tube.
- Do not pull your PEG tube. It can move out of place or come out.
- Close your PEG tube and tape it to your stomach when you are not using it.
Can I take a bath or go swimming?
Yes. You can do your normal activities after the skin around your PEG tube heals. Be sure it is closed before getting into a pool or tub.
What can I put in a PEG tube?
Liquid, such as formula, fluids, and medicines can be put through the PEG tube. Do not put pills into your PEG tube.
A dietitian will talk with you about the commercial formulas that are best for you. They will help you get a balanced diet with all the vitamins and minerals you need. They will talk to you about how much and how often to give yourself the formula. Use these formulas so your tube does not get blocked.
Before you start putting medicine or feedings in the tube, check for:
- Leftover liquid in your PEG tube and stomach
- Cracks or breaks in the PEG tube
Will I give myself feedings at normal meal times?
- Follow the instructions from your dietitian.
- Give yourself feedings at any time during the day or night. Some people feed themselves at normal mealtimes. Some people choose other times during the day or overnight.
- No matter when you feed yourself, it may be nice to sit with your family during meals to share and talk. Also, be sure you choose feeding times that let you get enough sleep.
Can I give myself medicine through a PEG tube?
You can give yourself medicine that is liquid or finely crushed and dissolved in water. Never mix medicines. Always flush the tube with a little water between each medicine and after the last medicine is given.
Will I taste anything?
Your taste buds are on your tongue. So, you will not taste food given through your PEG tube. You might be able to taste something if you burp after a feeding.
Can I eat or drink after a PEG tube is put in?
It depends why you needed the PEG tube. Talk with your care team about eating and drinking.
It is often okay to eat and drink if you needed the PEG tube because of:
- Weight loss
- Not being able to gain weight
- Just in case you are not able to eat enough
If your care team tells you it is okay to eat and drink, you cannot do so until your gag reflex returns.
Talk with your care team about what is safe to eat and drink if you:
- Have problems swallowing
- Aspirate (food or drink goes down your windpipe into your lungs)
- Needed the PEG tube to keep your stomach empty
Some people should not eat or drink anything. Some people can eat and drink different amounts and consistencies in certain positions.
What if the PEG tube falls out?
Do not panic if your PEG tube ever falls out. Put a clean, dry towel over the opening to catch drainage. Then, go to your doctor or emergency room to get another tube put in. The opening can close quickly, so get it put back in as soon as you can.
Will the PEG tube leak?
- It can leak a small amount. Clean and dry the skin around the tube if it does leak, so you do not get skin breakdown or sores.
- Keep gauze or absorbent pads on the PEG tube. This keeps the skin dry and protects your clothes. Take extra pads and clothes with you when you leave your home.
- The tube may need to be changed if it leaks more than a little.
Will people know I have PEG tube?
A PEG tube is small. It is hidden by your clothing. People will only know you have a PEG tube if you show them.
Will I have a PEG tube forever?
This depends on your weight, health, eating habits, and if you can swallow. Talk with your care team about this.