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Percutaneous endoscopic gastrostomy (PEG) is a procedure that places a tube through the abdominal wall and into the stomach.
What to Expect
Prior to Procedure
Your doctor may do the following:
- Physical exam
- Medical history
- Review of medicines
- Blood and urine tests
- X-rays of the abdomen
- Endoscopic examination of stomach—An endoscope is long tube with a camera at the end that can be put down the throat into the stomach.
Leading up to your procedure:
- Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
- Aspirin or other anti-inflammatory drugs
- Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)
- Do not eat or drink for at least eight hours before the procedure.
- Arrange for a ride to and from the hospital.
- Local anesthesia—usually a lidocaine spray to numb the throat
- Pain medicine is usually given through a vein in your arm
- Sedative—to help you relax
Description of the Procedure
You will be given antibiotics for the procedure.
An endoscope is a long thin tool with a light and camera. It will be inserted through your mouth, down your throat, and into your stomach. The camera will send images to a video monitor. The doctor will use the images to find the right spot to insert the PEG feeding tube.
A needle will be inserted through the abdominal wall and into the stomach at the chosen spot. Using the endoscope, the doctor will locate the end of the needle inside the body. A thin wire will be passed from the outside of the body, through this needle, and into the stomach. This wire will be grasped with a snare in the abdomen and pulled out through the mouth. There will be a thin wire entering the front of the abdomen, going into the stomach, and continuing up and out of the mouth. The PEG feeding tube will then be attached to this wire. The wire will be pulled back out from the abdomen. This will pull the PEG tube down into the body.
A small incision will be made in your abdomen. The tube will be pulled until the tip comes out of the incision in the abdominal wall. A soft, round bumper will be attached to the ends of the PEG tube. It will keep the tube secure. Sterile gauze will be placed around the incision site. The PEG tube will be taped to your abdomen.
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How Long Will It Take?
Will It Hurt?
Anesthesia prevents pain during the procedure. You may feel some discomfort. For a couple of days after the procedure, you may have minor pain and soreness at the incision site. This may feel like a pulled muscle. Your doctor can prescribe medicine to relieve this discomfort.
Average Hospital Stay
The usual length of stay is one day. Your doctor may choose to keep you longer if complications arise.
- When resting in bed, keep legs elevated and moving to avoid blood clots .
- Do not smoke.
- Take prescription pain medicine as instructed. Avoid taking aspirin or aspirin-containing products unless instructed otherwise.
- To promote healing, resume normal activities as soon as possible.
- Be sure to follow your doctor’s instructions .
- Learn to feed yourself properly through the PEG feeding tube:
- You will receive fluids through an IV for a day or two. Then, you will start to get clear liquids through the PEG tube. If this works well, you will start a formula feed through the tube.
- A dietitian will teach you how to use your PEG tube. She will also teach you how to choose an appropriate tube-feeding formula.
- Remain upright for 30-60 minutes after eating.
- Learn the proper care of your PEG tube.
- Change the sterile gauze pads around the incision site regularly.
- Wash the PEG tube and the skin around it regularly to avoid infection.
- Learn how to empty your stomach through the tube.
- Learn how to recognize and handle problems like a blocked tube or a tube that falls out of place.
- Tape the tube site when it is not in use to prevent dislodging.
American Society for Gastrointestinal Endoscopy
Oral Cancer Foundation
Dietitians of Canada
Avitsland TL, Kristensen C, Emblem R, et al. Percutaneous endoscopic gastrostomy in children: a safe technique with major symptom relief and high parental satisfaction.
J Pediatr Gastroenterol Nutr. 2006;43:624-628.
Ljungdahl M, Sundbom M. Complication rate lower after percutaneous endoscopic gastrostomy than after surgical gastrostomy: a prospective, randomized trial.
Surg Endos. 2006;20:1248-1251.
Overview—percutaneous endoscopic gastrostomy (PEG). Cleveland Clinic website. Available at:
. Accessed June 13, 2008.
Percutaneous endoscopic gastrostomy (PEG). American College of Gastroenterology website. Available at:
. Accessed June 21, 2009.
Percutaneous endoscopic gastrostomy (PEG). American Society for Gastrointestinal Endoscopy website. Available at:
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