PEG feeding tubes
A brain injury can result in the
muscles for chewing and swallowing becoming weak, slow and or
A Percutaneous Endoscopic Gastrostomy (PEG) feeding tube
can improve a person's nutritional intake and contribute to a
greater quality of life where there are severe swallowing
difficulties, which can lead to:
- food and water entering the lungs and causing chest
- eating less and inadequate nutrition.
A PEG tube passes directly into the abdominal wall so nutrition
can be provided without chewing or swallowing. A dietitian will
prescribe a suitable liquid formula containing protein, fat,
carbohydrate, fluid, vitamins and minerals. There are three main
ways that the liquid feed can be administered:
- bolus method where liquid is poured down a syringe into the
- a bag of liquid food is hung from a stand and drips through the
- an electric pump.
How PEG tubes are inserted
Insertion of the tube involves a minor surgical procedure which
takes about 30 minutes under a mild sedative or general
An endoscope is used to examine the inside of the stomach. After
the area has been anesthetized, a small incision is made through
the abdominal wall. A guide wire is inserted into the incision and
brought up through the endoscope into the stomach with the feeding
tube attached. The tube is prevented from moving by a small plastic
disc internally and a flange externally. A cap is placed over the
end of the tube when feeding is not taking place.
Is accidental removal of the tube
A common misconception when first learning about PEG
feeding is that if a person accidentally or deliberately pulls a
feeding tube out this can be life threatening for a person. This is
not life-threatening, but the tube does need to be correctly
reinserted by a trained person.
Common problems & solutions
The most common problems are blocked feeding tubes, exit site
infection, deteriorated tubes, incorrect feeding formula or
gastrostomy tubes that have been inadvertently removed.
Infection of the tube exit site can be avoided by washing the
site with warm water and soap and cleaning around the external
bumper with a cotton bud, ensuring that the area is also dried
thoroughly. After each feed, the tube should be flushed with
cooled, boiled water to avoid tube blockages.
The tube should be checked each day and any changes in the
appearance of the exit site e.g. redness, itchiness or presence of
discharge or the tube itself. Cracking or leakages should be
reported to the referring doctor immediately. A feeding tube will
generally last between one to two years and can be easily replaced
without hospital admission.
Best feeding position &
A person should never be positioned laying down flat. They
should lie with their head at a 30° angle or sitting upright in a
chair, remaining in this position for approximately 30 to 60
Some people may not tolerate a certain feeding formula. Adverse
reactions to the type of feeding formula can include nausea and
diarrhea. If you begin to experience these symptoms contact your
prescribing specialist as some experimentation may be required
before finding the type of formula and quantity that best meets the
References and further information
Links and References
. MND Victoria, Updated 2007.
Queensland Health. Updated 2007.
K Dollard,G Young, PEG Care and Support Service. 1999, Adelaide:
Flinders Medical Centre.
Hong Kong Geriatrics Society, Clinical Guidelines on Enteral
Tube Feeding. Amended ed. 2003, Hong Kong: Hong Kong Geriatrics
option=com_content&task=view&id=106&Itemid=108 . MND
Australia. Updated 2007.
For More Information
Gastrostomy Information Support Society http://www.giss.org.au
Gastroenterological Society of Australia http://www.gesa.org.au
Dieticians Association of Australia http://www.daa.asn.au