Nutrition and PEG Tube Insertion and Management

What is a Feeding Tube?

A feeding tube is a device that delivers liquid nutritional formula directly to the stomach in patients unable to feed themselves. It is also used to deliver medicines to the stomach or to remove gas or fluids from the stomach when necessary.

Indications for Feeding Tube

A feeding tube is usually recommended in patients who do not get sufficient nutrients orally due to certain illnesses. It can also help patients who have trouble eating due to mouth cancer, stroke, burns, or neurological disorders such as dementia or Parkinson’s disease that can make chewing or swallowing difficult.

Types of Feeding Tubes

Feeding tubes can be used for short-term or long-term purposes. Doctors commonly use nasogastric (NG) tubes in the short-term. The tube is inserted through your nose, passing down through the oesophagus and into the stomach. Insertion of a nasogastric tube does not require surgery and can be performed at the bedside. G-tubes or J-tubes are a long-term solution. A G-tube (gastric) is surgically passed directly into your stomach while a J-tube is inserted below the stomach into the middle part of your small intestine (jejunum).

Percutaneous Endoscopic Gastrotomy (PEG) Procedure

Insertion of a feeding tube is called percutaneous endoscopic gastrostomy (PEG) or G-tube insertion.

Before the Procedure

Inform your doctor of any medicines you are taking, including blood-thinners, anti-inflammatory medications, and many others. Do not eat or drink 6-8 hours prior to the procedure.

During the Procedure

The procedure includes the following steps:

  • PEG is performed under IV sedation. Local anaesthesia may be given at the placement site of the PEG tube. You may be given pain medications intravenously to manage any discomfort.
  • You will lie on your back. Your physician inserts an endoscope through your mouth and advances it down the oesophagus into the stomach. An endoscope is a long, thin tube fitted with a camera on the end which helps your surgeon visualize the internal organs of your body.
  • The exact site of the PEG tube is determined. A small incision is made in your abdomen and the PEG tube is inserted and secured with tape. A gauze dressing is placed.

After the Procedure

Your physician closely observes for any complications. A person must accompany you to drive you home. The gauze dressing will be removed after a few days. Your dietician will teach you how to use your PEG tube and how to care for the tube for long-term use. Your diet is usually liquid formula suggested by your doctor.

Complications of Feeding Tubes

Your normal activities should not be interrupted by a feeding tube. Complications are rare, but you should contact your doctor if you experience nausea, trouble breathing, fever, bleeding, swelling, pain or infection at the site of the tube.

Removal of a Feeding Tube

Removal of the feeding tube is performed by your physician once you regain your ability to feed yourself normally. A large syringe may be used to clear the tube. A disposable towel is held near the site to prevent spilling. Your doctor gently removes the tube from your abdomen. The incision is closed with a bandage (except in the case of a nasogastric tube).

Contraindications of a Feeding Tube

Your doctor may not recommend a feeding tube if you are diabetic, pregnant, or have certain conditions such as heart or lung disease or allergies.

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