Alternative Names stomach tube, gastrostomy tube, percutaneous endoscopic gastrostomy, PEG
Definition A gastrostomy is surgery to insert a tube through the abdomen into the stomach. This tube is most often used for feeding. It may also be used to keep the stomach empty.
Who is a candidate for the procedure? A gastrostomy tube is usually placed in the body when a person is unable to take in enough kilojoules to meet the demands of his or her body. It may be used for long-term nutritional support. Reasons a gastrostomy might be performed include:
emptying of the stomach after surgery when a nasogastric tube, or tube placed into the stomach through the nose, is not tolerated
How is the procedure performed? Some people who have this surgery are given general anaesthesia so that they are asleep when the gastrostomy tube is inserted. Other people may be given a local anaesthesia. This means that the area of the surgery is numbed with medication. Although the person is awake, he or she should feel no pain during the procedure.
To insert the gastrostomy tube, the surgeon will make a small cut on the side of the abdomen and into the stomach. A small catheter with a balloon on the end of it is inserted through the cut. The balloon is inflated to keep it in place in the stomach. The tube, which is made of polyvinylchloride or rubber, is then sutured to the skin.
Sometimes a different procedure, called a percutaneus endoscopic gastrostomy or PEG, is performed. A lighted scope is passed down the throat and through the oesophagus. The scope is advanced into the stomach. The light shows the surgeon where to make the incision in the skin and stomach. The tube is placed through the incision. The balloon is inflated and the tube is sutured to the skin.
What happens right after the procedure? An x-ray may be done before the gastrostomy tube is used for feeding. This is done to be sure that it is in the correct spot. Feedings will begin with clear liquids, and gradually be increased to thicker solutions. The head of the bed should be elevated to prevent the person from vomiting.
What happens later at home? The person and his or her family will be taught how to care for the feeding tube before leaving the hospital. They will learn:
how to care for the skin around the tube
the signs and symptoms of infection
the signs and symptoms of tube blockage
how to perform the feedings
what to do if the tube is pulled out
A visiting nurse may be needed until the family is comfortable with the feedings. A person can resume his or her normal activities a day or two after the gastrostomy.
What are the potential complications after the procedure? There are potential complications with any surgery. These include bleeding, infection, and allergic reaction to anaesthesia. The gastrostomy tube may become dislodged, or fall out and need to be replaced. Stomach contents can leak out of the tube causing skin irritation. The gastrostomy tube can become clogged. Other complications include stomach upset such as diarrhoea, cramping, and bloating.
Author: Gail Hendrickson, RN, BS Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
