Percutaneous endoscopic gastrostomy (PEG) is a procedure to place a tube through the abdominal wall and into the stomach.
A gastrostomy tube provides an alternative feeding site. It may be needed to: Feed a person who has a hard time sucking or swallowing, or who is otherwise unable to eatDrain the stomach of fluids that have built up
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like: PEG tube malfunctionAspiration—accidental sucking into the airways of fluid, food, or any foreign materialDamage to other organsInflammation of the lining of the abdomenInfectionBloatingNauseaDiarrheaIrritation of the skin near the tubeBlockageAn abnormal opening between two structures—fistula
Factors that may increase the risk of complications include: Chronic disorders, such as
diabetesSmokingAlcohol use disorder
drug abuseUse of certain prescription medicationsPrior abdominal surgeriesIncreased age
Your doctor may do the following: Physical examMedical historyReview of medicationsBlood and urine testsX-rays
of the abdomen
of stomach—An endoscope is long tube with a camera at the end that can be put down the throat into the stomach.
Leading up to your procedure:
Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.Do not have nutrition or fluids for at least 8 hours before the procedure.Arrange for a ride to and from the hospital.
Local anesthesia—usually a lidocaine spray to numb the throatPain medication is usually given with an IVTo help you relax, you may be give a sedative
You will be given antibiotics for the procedure.
An endoscope is a long thin tool with a light and camera. It will be inserted through your mouth, down your throat, and into your stomach. The camera will send images to a video monitor. The images will be used to find the right spot to insert the PEG feeding tube.
A needle will be inserted through the abdominal wall and into the stomach at the chosen spot. Using the endoscope, the doctor will locate the end of the needle inside the body. A thin wire will be passed from the outside of the body, through this needle, and into the stomach. This wire will be grasped with a snare in the abdomen and pulled out through the mouth. There will be a thin wire entering the front of the abdomen, going into the stomach, and continuing up and out of the mouth. The PEG feeding tube will then be attached to this wire. The wire will be pulled back out from the abdomen. This will pull the PEG tube down into the body.
A small incision will be made in your abdomen. The tube will be pulled until the tip comes out of the incision in the abdominal wall. A soft, round bumper will be attached to the ends of the PEG tube. It will keep the tube secure. Sterile gauze will be placed around the incision site. The PEG tube will be taped to your abdomen.
Percutaneous Endoscopic Gastrostomy Procedure
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Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
The usual length of stay is one day. Your doctor may choose to keep you longer if complications arise.
The hospital staff will monitor your breathing, heart rate, and pulse. Care may include: Medications to prevent pain or blood clotsElevating your legs while in bedMoving around to as soon as possible to promote healing
During your stay, the hospital staff will take steps to reduce your chance of infection such as: Washing their handsWearing gloves or masksKeeping your incisions covered and PEG tube protected
There are also steps you can take to reduce your chances of infection such as: Washing your hands often and reminding visitors and healthcare providers to do the sameReminding your healthcare providers to wear gloves or masksNot allowing others to touch your incisions or the PEG tube
A dietitian will teach you how to use your PEG tube. You will also be taught how to choose an appropriate tube-feeding formula.
The hospital staff will teach you how to take proper care of the PEG tube. This includes changing the dressing, cleaning the around the site, and monitoring for infection.
You may be given medications to ease pain or other symptoms. Follow any instructions on exercises to help with your recovery.
It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor: Pain that you cannot control with the medications you've been givenThe tube falls outProblems with the function of the tube or drainage around the tubeSigns of infection, including fever and chillsRedness, swelling, increasing pain, excessive bleeding, or discharge from the gastrostomy siteHeadaches, muscle aches, lightheadedness, or general ill feeling
constipation, or abdominal swelling
If you think you have an emergency, call for medical help right away.
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Percutaneous endoscopic gastrostomy (PEG). American College of Gastroenterology website. Available at:
Accessed December 6, 2013.
Percutaneous endoscopic gastrostomy (PEG).
American Society for Gastrointestinal Endoscopy website. Available at:
http://www.asge.org/publications/publications.aspx?id=394&terms=gastrostomy. Accessed December 6, 2013.
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Last reviewed June 2015 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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