Dr. Ertan Beyatlı

When is the stomach tube inserted? (PEG)

(Update: ) - Digestive System Diseases

Known by its abbreviation, PEG stands for Percutaneous Endoscopic Gastrostomy. In this method, a flexible feeding tube is inserted into the stomach through the anterior abdominal wall. PEG allows nutrition, fluids, and / or medications to be put directly into the stomach, bypassing the mouth and esophagus.

How is PEG made?

The patient is put to sleep as it is applied in the endoscopy procedure. First to make sure you are not obstructing the process endoscopy process is carried out. Afterwards, a gauze (guide) is sent into the stomach with the help of a needle through the anterior abdominal wall, and a flexible tube is inserted through the endoscope from the mouth to the stomach and is fixed to the anterior abdominal wall with stitches. Patients can usually go home the day after the procedure.

English, Percutaneous endoscopic gastrostomy

NCBI

Who can benefit from PEG?

Patients who have difficulty swallowing, have an appetite or have problems with inadequate nutrition by mouth can benefit from this procedure. The PEG catheter can be applied in the following situations:

  • Neurological diseases and psychomotor retardation
  • Cerebrovascular disease (in CVO patients)
  • Motor neuron disease (ALS - amyotrophic lateral sclerosis)
  • Multiple Sclerosis (MS - Multiple Sclerosis)
  • Parkinson's disease
  • Cerebral palsy (cerebral palsy)
  • Dementia (dementia)
  • Cerebral tumor
  • Psychomotor retardation
  • Decreased level of consciousness
  • Head injury
  • Intensive care patients
  • Prolonged coma
  • Cancer
  • Head and neck cancer
  • Esophageal cancer
  • Burns
  • Congenital anomaly (eg, tracheal esophageal fistula)
  • Fistula
  • Cystic fibrosis
  • Short bowel syndromes (Crohn such as disease)
  • Facial surgery
  • Poly-trauma
  • Chronic renal failure
  • HIV / AIDS
  • Gastric decompression
  • Abdominal malignancy

How to Care?

Following the procedure, a dressing will be placed in the area. This dressing is usually removed after a day or two. After that, the entrance area of ​​the tube should be cleaned once a day with diluted soap and water and should remain dry between cleaning. No special dressing or covering is required.

How is PEG used?

In addition to special liquid nutrition, fluids are delivered through the PEG tube. If the PEG tube is placed due to difficulty swallowing (eg after a stroke), there will be restrictions on oral intake. Some patients may continue to eat or drink orally after the procedure, but the physician who follows this must definitely decide.

What are the complications of the PEG procedure?

Yes, complications may occur with PEG placement. Possible complications include pain in the area, leakage of stomach contents around the tube, and dislocation or dislocation of the tube. Possible complications include infection at the site, aspiration (inhalation of gastric contents into the lungs), bleeding, and perforation (an unwanted hole in the intestinal wall).

How long do these tubes last? How to remove it?

PEG tubes can last for months or years. However, these may need to be replaced as they can disintegrate or clog over long periods of time. Your doctor can easily remove or replace a tube without sedatives or anesthesia, although in some cases he prefers to use sedation and endoscopy. Your doctor will remove the tube by pulling tight from the tube and insert a new tube or if a new tube is not needed, the application will be terminated. After the tube is removed, the hole in the abdominal wall closes quickly, therefore, attention should be paid to this issue in accidentally removed tubes and immediately inform the physician.

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