Percutaneous Endoscopic Gastrostomy (PEG) is a medical procedure used to insert a feeding tube directly into the stomach through the abdominal wall. This method is typically used for patients who are unable to eat by mouth due to various medical conditions, such as neurological disorders, head and neck cancers, or other conditions that impair swallowing.

Key Features of PEG

Procedure Overview

1. Preparation: The patient may undergo pre-procedure assessments, including imaging studies and lab tests. Fasting is usually required for several hours before the procedure.
2. Anesthesia: The procedure is generally performed under local anesthesia with sedation. The patient remains awake but relaxed and may not feel pain during the procedure.
3. Endoscopy: An endoscope (a flexible tube with a camera and light) is inserted through the mouth and into the stomach to visualize the area.
4. Insertion of the PEG Tube:
   • A small incision is made in the abdominal wall.
   • A needle is used to create a tract from the skin to the stomach.
   • The feeding tube is inserted through this tract and secured in place.
5. Completion: The endoscope is removed, and the site is cleaned and bandaged.

Indications for PEG

• Inability to Swallow: Conditions such as stroke, dementia, amyotrophic lateral sclerosis (ALS), or other neuromuscular disorders that impair swallowing.
• Long-Term Nutritional Support: Patients requiring long-term feeding due to chronic illnesses or post-surgical recovery.
• Cancer Treatment: Patients undergoing radiation or chemotherapy for head and neck cancers may need PEG for nutritional support.

Benefits

• Nutritional Support: Provides a reliable means of delivering nutrition and hydration when oral intake is insufficient.
• Minimally Invasive: The PEG procedure is less invasive compared to traditional surgical feeding tube placement, allowing for quicker recovery and less postoperative pain.
• Home Care: Patients can often return home after the procedure and continue care with appropriate training on tube management.

Risks and Complications

While PEG is generally considered safe, there are potential risks, including:

• Infection: At the insertion site or within the abdominal cavity.
• Bleeding: During or after the procedure.
• Perforation: Rarely, the endoscope may perforate the stomach or surrounding organs.
• Displacement or Blockage of the Tube: The tube may become dislodged or blocked, requiring replacement or intervention.
• Aspiration: Risk of food or liquid entering the lungs, particularly if the patient has difficulty swallowing.

Aftercare

• Monitoring: Patients should be monitored for signs of infection, bleeding, or complications.
• Tube Care: Proper cleaning and maintenance of the PEG tube are essential to prevent infection and blockage.
• Nutritional Management: Dietitian consultation may be needed to determine the appropriate formula and feeding regimen.

Conclusion

Percutaneous Endoscopic Gastrostomy is an effective procedure for providing nutritional support to patients unable to eat by mouth. While it offers significant benefits, careful consideration of risks, proper technique, and diligent aftercare are crucial for successful outcomes. If you have more questions about PEG or its suitability for a particular case, consulting with a healthcare professional is recommended.