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To prepare for PEG feeding tube, you need to stop solid food for eight hours or more. You may need to stop blood thinners up to 7 days before the test. You can take your essential medications like those for blood pressure the morning of your test.
What is a PEG feeding tube?
PEG stands for percutaneous endoscopic gastrostomy. It is a feeding tube that is placed through your abdomen into your stomach using an endoscope. A gastroenterologist is the specialist that usually perform this procedure. Feeding tubes can also be placed by an interventional radiologist or a surgeon.
When placed by a gastroenterologist, an upper endoscopy (EGD) is performed first. If everything looks right, a small incision is made on the belly, a wire is passed through this incision and the wire is used to guide the feeding tube into the stomach. Endoscopy confirms appropriate placement.
Why do you need a PEG feeding tube?
- Difficulty swallowing (dysphagia).
- Prolonged respiratory failure with use of ventilator and sedation.
- Cancer of the head and neck and esophagus.
- Severe malnutrition.
- To decompress the stomach in cases of gastric outlet obstruction.
What are the risks of PEG feeding tube
- Adverse reaction to anesthesia.
- Belly pain.
- Aspiration of food.
- Blockage of tube.
- Dislodgement of the tube.
- Buried bumper syndrome.
- Fistula formation.
- PEG tract tumor seeding.
What are the alternatives to a PEG feeding tube?
Few things can replace the PEG tube for some people. Nasogastric (NG) tube, nasojejunal tube, percutaneous endoscopic jejunostomy (PEJ) tube, and other feeding tubes placed by surgeons and radiologists are alternatives depending on the circumstances.
How do I prepare for my test
What do I do 1 week before the PEG feeding tube?
- Discuss all your medications with your provider.
- You may need to stop your antiplatelet or anticoagulants such as Coumadin, Plavix.
- You may continue to take your aspirin.
- Arrange for a driver to take you home after the procedure.
What do I do 2-3 days before the PEG feeding tube?
- You may need to stop anticoagulants like Eliquis, Pradaxa, and Xarelto 2-3 days before your PEG tube.
What do I do a day before the PEG tube feeding?
- Confirm your transportation with a responsible adult driver.
- No solid food 8 hours prior to your procedure.
What do I do on the day of the PEG tube feeding?
- You may take your essential morning medications with a few small sips of water, at least 4 hours before your procedure, unless as directed by your physician.
- Nothing by mouth at least 4 hours prior to your procedure including gum, hard candies, mints, tobacco.
- Leave your valuables at home.
- Bring your ID, insurance cards, and any co-pay with you.
What to expect during the procedure
You will be given medicines to make you sleepy. Most people do not remember the test. You will be given oxygen and monitored throughout the test. Your doctor will insert the gastroscope or endoscope through your mouth and examine the lining of your esophagus, stomach and small intestine.
Your belly is cleaned and a numbing medication is injected under the skin of your belly. A small incision is made on the belly, a wire is passed through this incision and the wire is used to guide the feeding tube into the stomach. Endoscopy confirms appropriate placement.
For most people, the procedure last 30 to 60 minutes.
What to expect after the procedure
You will be monitored until you are awake. Your doctor will give you specific instructions regarding your PEG tube. You will be told what kind of food you have pass through the PEG tube. Someone should drive you home.
How to take care of the PEG feeding tube
- Wash your hands with soap and water before touching your PEG tube.
- Remove the dressing 24 hours after your procedure.
- Clean the area around the PEG tube every day with soap and water. Keep it dry at other times.
- Gently twist the tube right and left every day to prevent a scab from forming around the tube entry into the skin.
- Check the skin around the tube for swelling, redness or leakage every day.
- Flush the tube with 60-100cc of warm water every day as well as after each tube feeds or medicine.
- Do not put a dressing or gauze between the PEG tube bumper and the skin.
How to use the PEG feeding tube
- The PEG tube may be used almost immediately. However, must physician recommend to wait for 4-6 hours after placement before use.
- Before use, wash your hands with soap and water.
- Clamp the tube for 30 minutes before giving yourself food.
- Flush the tube with 60-100cc of warm water.
- Sit upright during feeding.
- Put the liquid food into the PEG tube.
- After each use, flush the tube with 60-100cc of warm water.
- Close the cap of the tube and clamp the PEG tube.
- Continue to sit upright for about one hour after feeding yourself.