A Percutaneous Endoscopic Gastrostomy (PEG) tube is a medical device that provides a pathway for nutrition and medication directly to the stomach. It offers long-term nutritional support when an individual cannot consume adequate food or liquids orally. This tube bypasses the mouth and esophagus, delivering necessary nutrients to the digestive system.
Anatomy and Placement
A PEG tube has several components. An external bumper or disc rests against the abdominal skin, preventing the tube from sliding further into the stomach. Inside the stomach, an internal bumper, often a balloon or mushroom-shaped flange, holds the tube securely against the inner stomach wall. The tube shaft connects these two bumpers, extending through a small opening in the abdominal wall and into the stomach. At the outer end, a feeding port allows for connecting syringes or feeding sets, and a cap seals the tube when not in use.
PEG tube placement typically occurs in a hospital through an endoscopic procedure. This involves intravenous sedation and sometimes a local anesthetic. A flexible, lighted endoscope is guided through the mouth and esophagus into the stomach, allowing the healthcare provider to visualize the stomach lining and identify a suitable insertion point on the abdominal wall. A small incision is then made in the upper abdomen, and the PEG tube is guided through this incision into the stomach. The procedure usually takes 20 to 30 minutes.
Function and Feeding Methods
A PEG tube delivers liquid nutrition, fluids, and medications directly into the stomach. This direct route ensures individuals with swallowing difficulties or those unable to consume enough by mouth still receive adequate sustenance. Once connected to the feeding port, solutions flow through the tube and enter the stomach, where normal digestion proceeds.
Two primary methods exist for administering feeds through a PEG tube: bolus feeding and continuous feeding. Bolus feeding delivers a larger volume of formula over a short period, typically 10 to 20 minutes, several times a day, mimicking a traditional meal pattern and offering greater freedom of movement between feeds. Continuous feeding delivers formula slowly and steadily over an extended period, often 8 to 24 hours, usually with a feeding pump. This method may be preferred for individuals sensitive to larger volumes or at higher risk of aspiration, as it provides a more consistent nutrient flow. Medications, typically liquid or finely crushed and mixed with water, are also administered through the PEG tube, with flushing before and after each administration to prevent clogging.
Daily Care and Monitoring
Maintaining a PEG tube requires consistent daily care to ensure functionality and prevent complications. Regular flushing with water prevents formula or medication from accumulating and causing blockages. Flushing is often recommended before and after each feed or medication administration, and at least once daily even when not in use.
Cleaning the stoma site, the skin around the tube opening, is another routine task. This involves gently washing the area with mild soap and water daily, cleaning under the external bumper and around the tube itself. Thorough drying of the site after cleaning reduces the risk of irritation or infection. Securing the tube to the abdomen with tape or a specialized device helps minimize movement and pulling, preventing trauma to the insertion site. Regularly checking the tube’s position by noting a mark at skin level and rotating the tube a quarter turn daily helps prevent the internal bumper from adhering to the stomach wall and ensures proper placement.
Why a PEG Tube is Necessary
A PEG tube becomes necessary when individuals cannot safely or adequately consume sufficient nutrition and fluids by mouth over an extended period. This often arises from conditions impairing swallowing function, known as dysphagia. Neurological disorders like stroke, Parkinson’s disease, multiple sclerosis, or conditions affecting consciousness can lead to such difficulties.
Certain cancers, particularly those of the head and neck, or severe facial trauma, can also make oral intake challenging or impossible. In these situations, a PEG tube offers a reliable way to ensure the body receives necessary calories, hydration, and medications to maintain health and support recovery. It provides a consistent and safe means of nutritional support, allowing individuals to meet dietary requirements when traditional eating is compromised.