Feeding tube insertion - gastrostomy

  • Definition
    • A gastrostomy feeding tube insertion is the placement of a feeding tube through the skin and the stomach wall. It goes directly into the stomach.

  • Alternative Names
    • Gastrostomy tube insertion; G-tube insertion; PEG tube insertion; Stomach tube insertion; Percutaneous endoscopic gastrostomy tube insertion

  • Description
    • Gastrostomy feeding tube (G-tube) insertion is done in part using a procedure called endoscopy. This is a way of looking inside the body using a flexible tube with a small camera on the end of it. The endoscope is inserted through the mouth and down the esophagus, which leads to the stomach.

      After the endoscopy tube is inserted, the skin over the left side of belly (abdomen) area is cleaned and numbed. The doctor makes a small surgical cut in this area. The G-tube is inserted through this cut into the stomach. The tube is small, flexible, and hollow. The doctor uses stitches to close the stomach around the tube.

  • Why the Procedure Is Performed
    • Gastrostomy feeding tubes are put in for different reasons. They may be needed for a short time or permanently. This procedure may be used for:

      • Babies with birth defects of the mouth, esophagus, or stomach (for example, esophageal atresia or tracheal esophageal fistula)
      • Persons who cannot swallow correctly
      • Persons who cannot take enough food by mouth to stay healthy
      • Persons who often breathe in food when eating
  • Risks
    • Risks for surgical or endoscopic feeding tube insertion are:

      • Bleeding
      • Infection
  • Before the Procedure
    • You will be given a sedative and a painkiller. In most cases, these medicines are given through a vein (IV line) in your arm. You should feel no pain and not remember the procedure.

      A numbing medicine may be sprayed into your mouth to prevent the urge to cough or gag when the endoscope is inserted. A mouth guard will be inserted to protect your teeth and the endoscope.

      Dentures must be removed.

  • After the Procedure
    • This is most often a simple surgery with a good outlook. Follow any self-care instructions you're given, including:

      • How to care for the skin around the tube
      • Signs and symptoms of infection
      • What to do if the tube is pulled out
      • Signs and symptoms of tube blockage
      • How to empty the stomach through the tube
      • How and what to feed through the tube
      • How to hide the tube under clothing
      • What normal activities can be continued
  • Outlook (Prognosis)
    • The stomach and abdomen will heal in 5 to 7 days. Moderate pain can be treated with medicine. Feedings will start slowly with clear liquids, and increase slowly.

  • References
    • Davis PW. Percutaneous endoscopic gastrostomy placement and replacement. In: Pfenninger JL, Fowler GC, eds. Pfenninger and Fowler's Procedures for Primary Care. 3rd ed. Philadelphia, PA: Elsevier Mosby; 2011:chap 200.