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Percutaneous Endoscopic Gastrostomy (PEG) placement is a minimally invasive medical procedure to insert a feeding tube directly into the stomach through the abdominal wall. This procedure is an alternative to an open surgical Gastrostomy. This procedure is mostly required when oral intake is difficult and you cannot get all nutrition by mouth due to difficulty swallowing. Another feeding alternative is by inserting a PEG-J tube extension via the pylorus into the small intestine to provide liquid feed and medicines directly into the small bowel.`
During the PEG placement, a small incision is made on the left side of the abdomen. The stomach is then perforated to make room for a flexible catheter with a flared or ballooned tip. Nutrition is directly delivered to the stomach with the use of this catheter. For individuals who are unable to swallow food, enteral feeding—also referred to as PEG or G-tube insertion—provides a dependable way of providing long-term nutrition. PEG placement is often indicated for patients who are unable to maintain adequate oral nutrition due to conditions such as stroke, neurological disorders, head and neck cancers, or severe swallowing difficulties.
Manipal Hospitals, Broadway, has a team of experienced gastroenterologists proficient in performing percutaneous endoscopic gastrostomy in Kolkata to enhance the quality of life for individuals with chronic feeding problems.
A liquid dietary formula is delivered straight to your digestive tract through an enteral feeding tube. Your physician or dietitian will recommend a formula that is specifically designed to meet your nutritional needs. The right proportions of lipids, proteins, carbs, vitamins, minerals, and other important micronutrients will all be included in this formula. Feeding tubes can be used to deliver fluids and drugs in addition to nourishment. When delivering formula through feeding tubes, there are various techniques employed. While some tubes dispense the formula into the digestive tract using a syringe or pump, others use gravity.
The following general preparation general preparation is needed for PEG tube placement:
Avoid eating and drinking, even water, for at least six hours before the surgery.
In the week before the surgery, you may also be subject to special dietary and/or medication requirements. For more specific instructions, please speak with your doctor.
After the procedure, make arrangements for a reliable person to drive you home. It is usually administered intravenously, so you will be advised not to drive or go back to work until the next day.
Inform your doctor of any allergies to latex, specific needs, medical problems, or prescriptions you are currently taking.
A PEG tube may help if you have trouble swallowing. This happens because of:
Brain injury
Head and neck cancers
A stroke
Dysphagia
Loss of appetite due to serious illnesses like cancer
Feeding tubes may help if you have trouble processing food
PEG tubes can help with cystic fibrosis, kidney failure, or coma
If a person eats a diet very low in protein and calories for more than 30 days, they may become malnourished
Other medical conditions like multiple sclerosis, Parkinson’s disease, cerebral tumours, abdominal or oesophagal malignancy, neurological diseases, HIV/AIDS, Crohn’s disease, short bowel syndrome, and distal gastric obstruction
Impaired self-feeding, GI obstruction, and need for gastric decompression
PEG feeding is a way to give food and nutrients to people who have a working digestive system. The procedure is becoming more common around the world because it's effective, safe, and not too expensive. Some of its advantages include:
It's more tolerable than nasogastric tubes and has good tolerance
The state of nutrition has improved
Caregivers reported that this method is easier to use than oral or nasogastric feeding
Home carers' report usage is satisfactory
Minimal frequency of problems
A decrease in aspiration pneumonia is linked to difficulties in swallowing
Economic in comparison to other approaches, especially if a respectably long survival is anticipated
While complications after PEG tube implantation are uncommon, there are still concerns to be aware of, such as abdominal haemorrhage or infection, aspiration-related lung infections, and oesophagal, stomach, or small intestinal rips. Additionally, there is a chance that the tube may inadvertently slip out or move, or it may become obstructed by food particles or medication. To prevent the hole from closing, replace the tube as soon as it moves. The PEG tube can be used to provide medication, but caution must be taken to prevent obstructions. Blockages can be avoided by flushing the tube after each use. Certain medications may need to be prepared differently for PEG delivery.
Following PEG implantation, recovery usually takes one to two weeks. There may be a little soreness at the insertion site that goes away in a few days. For observation, patients might need to spend a little time in the hospital. They are given instructions on how to handle feedings, keep themselves clean, and take care of the tube. To avoid obstructions, the area needs to be kept dry and clean, and the tube needs to be cleaned after every use. Appointments for follow-up guarantee appropriate recovery and operation. Usually, one can return to normal activities gradually, as tolerated.
PEG (Percutaneous Endoscopic Gastrostomy) tubes can wear out or clog over time, but they usually remain for months or even years. Pits, indentations, seepage, and lumps on your PEG tube are some indications that it needs to be changed. In most cases, your doctor can replace your PEG tube without the need for invasive surgery or anaesthesia. When the tube is no longer needed, your doctor might decide to remove it completely; in this case, your stomach's opening will shut on its own.
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