Feeding Tube Placement
Putting in a feeding tube, medically known as a percutaneous endoscopic gastrostomy (PEG), is a safe and effective way to provide food, liquids, and medications (when appropriate), directly into the stomach through a tube placed in the abdomen. The procedure is done for people who are having difficulty swallowing and can't consume enough food or liquids by mouth to maintain adequate nutrition.
What happens during the PEG placement?
During the procedure, a doctor places an endoscope (a tube with a camera on it) into your mouth. The endoscope is then advanced through your esophagus into your stomach. The camera on the endoscope produces pictures of your stomach, which are used to ensure correct positioning of the PEG tube. The feeding tube, which is inserted through an incision in your abdomen, rests in the stomach and exits through the skin.
What happens before the procedure?
You will meet with a doctor, dietitian, and home care coordinator. They will review your history, discuss the procedure, and answer any questions you might have.
Tell the doctor if you are pregnant, have a lung or heart condition, or if you are allergic to any medications. Also, tell your doctor if you have an artificial heart valve or if you have ever been told that you need to take antibiotics before a dental or surgical procedure. If so, you may need to take antibiotics before the PEG procedure.
If you have diabetes and use insulin, you may need to adjust the dosage of insulin the day of the test. Your diabetes care provider will help you with this adjustment. Bring your diabetes medication with you so you can take it after the procedure.
Tell your doctor if you are taking blood-thinning medications such as aspirin, Coumadin®, Persantine®, or Plavix®. You may need an alternate method for thinning your blood before the procedure.
For the week before the procedure, do not take aspirin, products containing aspirin, or anti-inflammatory drugs (such as ibuprofen, Advil®, Motrin®, Naprosyn®, and Indocin®).
Please note: Do not discontinue any medication without first consulting with your doctor.
Also, make arrangements to have a friend or loved one to drive you home following the procedure. You should not drive or operate machinery for at least eight hours. The medication given during the procedure may cause drowsiness, making it unsafe for you to drive or operate machinery.
Lastly, you may need to stay overnight in the hospital after the procedure, so please pack any personal items that you may need.
Can I eat before the procedure?
Do not eat or drink anything for eight hours before the procedure.
What happens on the day of the procedure?
You will meet with a doctor who will explain the procedure in detail, including possible complications and side effects. The doctor will also answer any questions that you may have.
What happens during the procedure?
You will be asked to wear a hospital gown and remove your eyeglasses and dentures.
You are given a pain reliever and sedative intravenously (in your vein). You will feel relaxed and drowsy. You are also given a local anesthetic (pain-relieving medication) at the site where the PEG tube is placed.
The doctor inserts an endoscope through your mouth and into your stomach. This tube does not interfere with your breathing. Through a camera on the endoscope, your doctor will view the stomach lining to determine the PEG tube insertion site.
A small incision is made in the abdominal wall to insert the feeding tube.
The procedure takes between 30 and 45 minutes to complete.
What happens after the procedure?
Immediately following the procedure, you will be observed closely for any complications such as an infection developing or bleeding occurring.
The PEG tube will be secured to your abdomen with tape. You should expect to see some drainage around the PEG tube for the first 24 to 48 hours. A sterile gauze dressing will be placed around the incision. Your nurse will change the dressing as needed. Once the dressing has been removed and the area has healed, be sure to wash the area daily with soap and water.
A dietitian will teach you how to use and care for your PEG tube, and you will be started on enteral tube feeding (feeding directly through the gastrointestinal tract). Your dietitian will help you choose a commercially prepared formula for the tube feeding.
For a couple of days, you may have minor soreness in your abdomen where the PEG tube was inserted. This will feel like a pulled muscle. You will receive medication to help relieve this pain the first day after the procedure.
The amount of care needed for the PEG tube varies among patients. Generally, PEG tubes do not need to be replaced for several months and may even function well for two or three years.
If you are having difficulty with your tube, please call your doctor or nurse.
When should I call the doctor?
Call your doctor immediately if:
- The tube comes out
- You find the tube becoming blocked
- You are unable to take food through the tube
- You have a lot of drainage around the tube
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 10/13/2008...#10348