A common question arises when discussing nutritional support: what is the difference between a general “feeding tube” and a “PEG tube?” The confusion stems from the fact that a feeding tube is a broad, overarching classification for any medical device used to deliver nutrition, fluids, or medication directly into the gastrointestinal (GI) tract. This process is known as enteral nutrition, which bypasses the need for safe oral consumption. A Percutaneous Endoscopic Gastrostomy (PEG) tube is a highly specific type of feeding tube, distinguished primarily by its method of placement and its intended duration of use.
Understanding Enteral Feeding Tubes (The General Term)
A feeding tube is any flexible medical device designed to supply nutrients directly to the stomach or small intestine, ensuring the body receives necessary calories and hydration. This method is employed when a person cannot safely or adequately meet their nutritional needs by mouth, yet their GI tract remains functional for digestion and absorption. The need for enteral feeding often arises from conditions like severe swallowing difficulties (dysphagia), certain cancers, critical illnesses, or neurological disorders that impair the ability to eat.
Bypassing the mouth and esophagus with a feeding tube helps prevent the dangerous complication of aspiration, where food or liquid enters the lungs. The overarching category of feeding tubes is classified according to where they enter the body and where they terminate in the digestive system.
Short-Term Non-Surgical Access Routes
Feeding tubes placed through the nose or mouth are typically intended for short-term nutritional support. These are considered non-surgical access routes because they are inserted through a natural body opening. The most common of these is the nasogastric (NG) tube, which passes through the nose, down the esophagus, and into the stomach. Similarly, a nasojejunal (NJ) tube is advanced further, past the stomach and into the small intestine (jejunum).
The orogastric (OG) tube is another temporary type, inserted through the mouth into the stomach, often used in infants or unconscious patients. These trans-nasal tubes are the preferred option for patients requiring feeding for a limited time, such as a few weeks. Because these tubes pass through sensitive areas, they are less comfortable for long-term use and are prone to dislodgement or irritation.
The PEG Tube: Placement and Purpose
The PEG tube (Percutaneous Endoscopic Gastrostomy) is a specific type of feeding tube designed for extended or permanent nutritional support. It is placed directly into the stomach through the abdominal wall. This placement requires an endoscopic procedure, where a flexible tube is guided down the throat to help the physician visualize the inside of the stomach.
During the procedure, a small incision is made in the abdominal skin, and the tube is passed through this opening into the stomach. The tube is secured internally with a bumper or balloon. This method bypasses the mouth and throat entirely, offering a stable and comfortable access point for months or even years of feeding.
Summary of Key Differences in Application
The primary distinction between a PEG tube and the broader category of feeding tubes lies in three application factors: placement route, duration, and method of insertion. Short-term feeding tubes, such as NG and NJ tubes, utilize a nasal or oral placement route, traversing the esophagus to reach the stomach or small intestine. The PEG tube, conversely, uses a direct abdominal wall route into the stomach.
Regarding duration of use, non-surgical tubes are generally temporary, intended for periods less than four to six weeks. The PEG tube is designed for long-term duration, often extending for months to years when chronic feeding support is needed. Finally, the placement method for short-term tubes is non-surgical, while the PEG tube requires an endoscopic and surgical procedure to create the opening in the abdomen and secure the device.