Percutaneous endoscopic gastrostomy (PEG)

Gastrostomy feeding is recommended if your digestive system is still working well but nutritional support is likely to be needed for more than a few weeks. It may be used for people whose cancer is blocking the gullet and so nasogastric feeding cannot be used.

Gastrostomy feeding involves surgically creating an opening, known as a fistula, through the abdominal wall. A feeding tube can then be passed through the opening and into the stomach. The feeding tube is held in place with either a stitch, a small inflated balloon around the tube just under the skin, or a flange around the tube just under the skin.

How a PEG is put in
Before a PEG is put in, the procedure will be explained to you by a doctor or specialist nurse. You will be asked to sign a consent form to say that you agree to having the PEG put in and that you understand why it is being done.

You will need to have nothing to eat or drink for 6–8 hours before the procedure, to make sure that your stomach is empty. You will be given antibiotics and may be asked to use an antiseptic mouthwash to reduce the risk of any infection developing.

You will be given a sedative to make you feel sleepy. A flexible tube with a light at the end (an endoscope) is passed into your mouth, down your gullet and then into the stomach. The stomach is inflated with air and the endoscope is positioned so that the light at the end shines through the abdominal wall to show the position of the stomach.

The skin of the abdominal wall is then cleaned and a local anaesthetic is used to numb the area. A small cut is made through the skin and muscle through which a feeding tube is inserted into the stomach.

Following the procedure the area around the tube (known as the tube site) is cleaned. A dressing is not usually necessary unless there is leakage of fluid from the site. The area around the tube needs to be cleaned daily with soap and water and thoroughly dried. The tube needs to be flushed with 30mls of water before and after each feed. It takes approximately three weeks for the skin to heal around the tube, and during this time it is recommended that you do not get the area wet. It is fine to shower as long as the exit site is protected. It is also fine to wash, but bathing should be avoided.