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Percutaneous Endoscopic Gastrostomy

Authors:
  • Amy Scholten, MPH
Publication Type:

Procedure

Percutaneous Endoscopic Gastrostomy

(PEG)

Definition

Percutaneous endoscopic gastrostomy (PEG) is a procedure to place a tube through the belly wall. The tube will connect to the stomach.

Reasons for Procedure

A PEG makes a new path to get nutrients if the normal path is blocked. It may be needed to:

  • Feed a person who has a hard time sucking or swallowing, or is unable to eat
  • Drain the stomach of a buildup of fluids

Possible Complications

Problems are rare, but all procedures have some risk. Your doctor will go over some problems that could happen, such as:

  • Aspiration—accidentally sucking fluid, food, or any foreign material into the airways
  • Damage to other organs
  • Inflammation of the belly lining
  • Infection
  • Bloating
  • Diarrhea
  • Irritation of the skin near the tube
  • Blockage

Things that could raise the risk of problems are:

  • Smoking
  • Drinking excess alcohol
  • Chronic diseases such as diabetes or obesity
  • Have had prior surgery in the area

What to Expect

Prior to Procedure

The care team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before the procedure
  • Fasting before the procedure, such as avoiding food or drink after midnight the night before
  • Whether you need a ride to and from the procedure

Anesthesia

The doctor will give local anesthesia. The area will be numbed. A sedative may be given to help you relax.

Description of the Procedure

The doctor will pass a scope through the mouth and into the stomach. The scope has a camera that will send images to a screen in the room. This will help the doctor find the right place for the PEG tube. Other tools can also be passed down the tube.

A needle will be placed through the belly wall and into the stomach. A thin, long wire will be passed through the needle, and into the stomach. A snare from the tube will grasp the wire and pull it out through the mouth. The PEG tube will then be passed over the end of the wire. The wire will be pulled back down into the stomach. It will pull the PEG tube into the stomach and out through the belly wall. A small incision may be made in the skin to allow tube to pass through skin. A bumper inside the stomach will stop the PEG tube out from leaving the stomach. The wire will be removed. A second bumper will be placed around the PEG tube outside the belly wall. This will keep the tube from sliding in. A bandage will be placed over the area. The PEG tube will be taped to the belly.

Percutaneous Endoscopic Gastrostomy Procedure

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How Long Will It Take?

30 to 45 minutes

Will It Hurt?

Anesthesia will prevent pain during the procedure. There will be some soreness for a few days after the placement. Medicines can help.

Average Hospital Stay

The usual length of stay is overnight. If you have problems, you may need to stay longer.

Post-procedure Care

At the Hospital

After the procedure, the staff may give medicine to:

  • Ease pain
  • Stop blood clots

During your stay, the hospital staff will take steps to lower your risk of infection such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

During your stay, you can also take steps to lower your risk of infection such as:

  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your tube

At Home

You will need to:

  • Take care of the PEG tube. This includes changing the dressing and cleaning the around the site. You will also need to watch for signs of infection.
  • Follow nutrition plan given by your care team.

It will take a few weeks for the skin around the tube to heal.

Problems to Look Out For

Call your doctor if you have:

  • Signs of infection, such as fever and chills
  • Redness, swelling, pain, excess bleeding, or discharge from the PEG site
  • Pain that you cannot control with the medicines
  • A tube that falls out—could lead to closing of opening if not replaced quickly
  • A tube that is not working as it should
  • Headaches, muscle aches, lightheadedness, or general ill feeling
  • Nausea, vomiting, problems passing stool (poop), or belly swelling

If you think you have an emergency, call for medical help right away.

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References

  • Balogh B, Kovács T, et al. Complications in children with percutaneous endoscopic gastrostomy (PEG) placement. World J Pediatr. 2019;15(1):12-16.
  • Enteral nutrition support in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/enteral-nutrition-support-in-adults. Accessed May 18, 2022.
  • Percutaneous endoscopic gastrostomy (PEG). American College of Gastroenterology website. Available at: http://patients.gi.org/topics/percutaneous-endoscopic-gastrostomy-peg. Accessed May 18, 2022.
  • Understanding percutaneous endoscopic gastrostomy (PEG). American Society for Gastrointestinal Endoscopy website. Available at: https://www.asge.org/home/for-patients/patient-information/understanding-peg. Accessed May 18, 2022.
Last Updated:
2023-06-01

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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.