PEG Feeding Tube Placement/Removal

During percutaneous endoscopic gastrostomy (PEG), a feeding tube is inserted through the abdominal wall into the stomach during an upper endoscopy. The procedure is also known as PEG tube placement, feeding tube placement, gastrostomy tube (g-tube) insertion, or stomach tube insertion.

The procedure allows nutrition, fluids, and medications to be put directly into the stomach, bypassing the mouth and esophagus. It is performed for patients who cannot eat or drink by mouth, such as those with:

• Neurologic conditions associated with poor swallowing, e.g., stroke or Alzheimer’s disease
• Oral or esophageal cancer, which can prevent patients from swallowing
• Other diseases of the esophagus that decrease a patient’s ability to swallow
• Birth defects of the mouth, esophagus, or stomach

A PEG tube allows patients to receive adequate nutrition and prevents respiratory problems that develop when food or fluids accidentally gets into the lungs. Gastrostomy tubes may be needed temporarily or permanently.

How to Prepare for a PEG Tube Placement

Do not eat or drink anything (including water) for 6 hours before the procedure. Your doctor will let you know if or when you should adjust or stop any medications you take. Because you will be sedated, you will need someone to drive you home after the procedure.

What to Expect

A PEG tube is placed during an upper endoscopy. A mouth guard will be placed to protect your teeth and gums. Your throat may also be numbed with a spray to calm the gag reflex. You will receive pain-relieving medication and sedation through an IV line to relax you and make you feel drowsy. Your doctor will insert the endoscope through your mouth and esophagus into your stomach.

The doctor will make a small incision in the abdomen and place the PEG feeding tube though this incision into the stomach. The feeding tube is a small, flexible, hollow tube, about the same width as a writing pen.

Approximately 6 to 12 inches of tubing will protrude from the incision area. Inside the stomach, the end of the tube is fitted with a balloon or flared tip to keep the tube from migrating forward into the stomach.

The outside end of the feeding tube has a capped plug to prevent stomach contents from spilling out. It is opened to allow food, medications, and water to be placed through the PEG feeding tube. The simplest method of providing nutrition through the tube is with a specialized formula administered through a large syringe. The contents of the syringe are injected through the plug cap on the end of the PEG feeding tube.

PEG tube placement typically takes 30-45 minutes. After the procedure, you will be taken to the recovery room while the sedative wears off. You may experience temporary discomfort, such as cramping from gas or abdominal pain from the incision, which can be managed with medications. Your doctor will discuss any unexpected side effects that may occur and a plan to address them. The stomach and abdomen will heal in 5 to 7 days.