Having a percutaneous
endoscopic gastrostomy
tube
Information for patients
Endoscopy
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Percutaneous Endoscopic Gastrostomy tubes are known as PEG tubes.
What is a PEG tube?
A PEG tube is a feeding tube that is inserted into your stomach and
through which liquid food is given. A PEG tube can be used if you need:
• Temporary liquid feeding to support you when you are finding it
difficult to eat or drink. Once your condition improves you would
normally be able to return to eating.
• Extra liquid feed because for some reason you cannot eat enough
food to keep healthy.
• To be given more fluids than you can drink normally.
• Long term liquid feeding support.
Feeding port
Y - adaptor
Medication /
flushing port
External
fixation
device
Clamp
Internal fixation device
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Why might I be offered a PEG tube?
There are various medical reasons why you may need a PEG tube. These
can include:
•
•
•
•
Difficulties swallowing food and/or fluids
You are unable to eat enough to meet your needs
You are unable to drink enough to meet your needs
If you suffer from a progressive type of illness and are well
nourished at the moment, a PEG tube can help maintain you in
this condition.
How will having a PEG tube help me?
A PEG tube allows you to get all the nutrition you need.
If eating and drinking has been a struggle, or if mealtimes are taking up
more time than you would like, the additional liquid feeds given via the
PEG tube will remove this pressure. This means that you will be free to
do the things you would like to do. Feeding with a PEG tube gives you
the balanced diet you need to feel better, have more energy and resist
infection.
Will I still be able to eat and drink normally?
Some people who have a PEG tube do have to stop eating and drinking
normally. However, if your speech and language therapist has told
you it is safe to do so, you can eat and drink whilst you have PEG tube.
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How is the PEG tube inserted?
PEG tubes are inserted using an endoscope. An endoscope is a flexible
tube used to look inside a person’s stomach. The endoscope is passed
through the mouth, down the throat and then into the stomach. Once
it is in place, the PEG tube is fed down the endoscope and passed
through a small incision in the outside of your stomach. When the PEG
tube has been placed the endoscope is removed leaving the PEG tube
in position through the stomach wall. (See diagram below).
Stomach
Skin
Internal
fixation
device
External
fixation
device
What if I am already being fed with a nasogastric tube?
You may already have a nasogastric tube to feed you. If this is the case
a PEG tube is being offered because either:
• Your nasogastric tube has become dislodged and you are not
getting enough liquid feed through it, or
• We feel that you would be more comfortable without a tube in
your nose. The PEG tube is easily hidden under your clothes and is
more comfortable.
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What happens if I agree to a PEG tube being placed?
If you agree to a PEG tube and you are not already in hospital, you will
need to come in. An appointment will be made for you to have the PEG
placed in the Endoscopy Unit. You will not be allowed to eat or drink for
several hours before the tube is fitted. This will also apply if you receive
liquid feeds through a nasogastric tube.
In the Endoscopy Unit you will be given antibiotics through a small
needle in the back of your hand. You will also be given an injection
(sedation) through the needle in your hand which will make you feel
drowsy or sleepy. Once the sedation has taken effect the endoscope is
passed into your stomach. A small incision will be made on the outside
of your stomach for the PEG tube to pass through.
Will it hurt to have a PEG tube placed?
Throughout the whole procedure you will either be drowsy or asleep.
You may be aware of the the endoscope being passed and removed
because this can cause some discomfort in your throat, both during and
after the procedure but this should wear off quite quickly.
How long does it take to have a PEG tube placed?
It usually takes between 15 and 20 minutes.
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What are the risks in having a PEG tube placed?
Placing a PEG tube is a comparatively safe procedure that means it can
be used for patients who may be elderly, frail or ill for other reasons.
However, as with many medical and surgical procedures the placing of
a PEG tube does carry some risks.
For some patients, particularly those with chest problems, the sedation
we use can cause some problems although it is safer than a general
anaesthetic. All patients are monitored throughout the procedure to
guard against any problems arising from sedation. If you would like
further information about sedation then please ask to see the booklet
‘You and your anaesthetic’
(www.rcoa.ac.uk/document-store/you-and-your-anaesthetic).
During the procedure a small needle is passed directly into the stomach.
Occasionally, a small quantity of air escapes into the abdomen but this
rarely causes a problem. A rarer but more serious complication is the
leaking of gastric fluid. This may cause inflammation in the lining of the
abdomen (peritonitis) that may need surgery to correct.
Problems can also arise once the PEG tube is in position but are seldom
serious. For example, infections may occur around the tube site. These
occasionally require a course of antibiotics to treat the infection.
How do I use the PEG tube to feed?
Your PEG tube will not be used for the first 6 hours after it is fitted and
for the following 6 hours you will only be allowed sterile water through
the tube. After this time you can start PEG tube feeding. The dietitian
will organise a feeding plan especially for you using liquid feeds.
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How do I look after my PEG tube?
For the first 2 days after the PEG tube has been placed the site on your
stomach will be cleaned with normal saline solution.
From day 3 onwards the site can be cleaned with mild soap and warm
water and gently dried. You will be given an information booklet telling
you about the care of your tube in more detail. You and your carer will
also be given training by the ward staff.
How will I feel?
After the PEG tube is in place you may find you get some redness,
leakage or local inflammation at the PEG tube site. This will be treated
by the nursing staff and usually clears up after a few days. You may find
that your mouth and lips get very dry. If this happens, a mouth wash
may help and a lip balm or moisturiser used regularly will help to prevent
your lips getting cracked and sore.
Can I have a bath, shower or go swimming with a PEG
tube in?
For the first 2 weeks you should not cover the tube site in water and
should have showers not baths.
In about 2 – 3 weeks the area around your PEG tube should have healed
fully. You will then be able to bath, swim, or shower without any
problems.
Always remember to close both ends of the tube’s ‘Y’ adaptor (see
diagram at the front of this booklet), before going into water.
Always remember to dry the skin around the PEG tube and the tube
itself afterwards.
page 8 of 12
What about cleaning my teeth?
If you have a PEG tube and get all of your liquid feed through it, it is easy
to forget to clean your teeth.
However, even if you are not eating and drinking, plaque can still build
up on your teeth very quickly. It is important that you clean your teeth
at least twice a day.
How often does a PEG tube need to be replaced?
The PEG tube is made of a long lasting polyurethane and normally will
not need replacing for 2 years. To help make sure that it does not need
replacing sooner it is important that the tube does not get blocked. To
help prevent blockages you must flush it through with water before and
after having a liquid feed or any medications.
Remember, nothing other than the liquid feed, medication or water
should be put down the PEG tube.
If you need to have your PEG tube replaced or removed you will need to
come back to the hospital, or it may be possible to arrange for this to be
done in your home.
What happens when I go home?
If you decide to have a PEG tube, the dietitian will visit you and your
carer before you leave hospital, and when you get home. The dietitian
will explain the feeding plan and provide the feed and any equipment
you need. The dietitian will also contact your GP so that they can
arrange for prescriptions for future feeds. We can arrange for you to
have a home delivery of the liquid feed and equipment if you wish.
page 9 of 12
Do I have to say yes now?
No, you don't need to make a decision now. Please feel free to talk over
any problems or questions you have with your doctor, nurse, dietitian,
family or carer before you decide. Even if you do not feel ready to have
a PEG tube now, at least you now know how it might help you. You can
discuss having a PEG tube again later when you feel ready.
page 10 of 12
page 11 of 12
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© Sheffield Teaching Hospitals NHS Foundation Trust 2015
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PD3696-PIL173 v4
Issue Date: July 2015. Review Date: July 2017