Percutaneous endoscopic gastrostomy (PEG) is a procedure to insert a tube into the stomach through the overlying skin for delivery of nutritional products and medication or as a means to drain the contents of the stomach. The procedure is guided by endoscopy in which a lighted tube with a camera is inserted through the mouth to view the inside of the stomach and correctly position the percutaneous tube.

A PEG tube insertion is recommended for patients with swallowing difficulties as a result of neurological disorders such as a stroke or brain injury; cancer or recent surgery of the upper gastrointestinal tract. Drainage may be needed to decompress the stomach in cases of intestinal obstruction due to tumors or other causes.

Before PEG tube placement, fasting is recommended and medications that affect blood clotting are either stopped or altered. The procedure is performed under local anesthesia with sedation. The endoscope is inserted through the mouth into the stomach. The stomach is suctioned and filled with air through the endoscope for better visualization. The inner lining of the stomach is observed and a suitable site for PEG tube insertion chosen. A small incision is made in the skin over the chosen site through which the PEG tube is passed. A sterile dressing is placed over the insertion site and tape is used to secure the PEG tube to the abdomen. The entire procedure takes around 30-45 minutes.

Following the procedure there may be some drainage and soreness at the insertion site for a day or two. Your doctor will prescribe pain medications. Instructions on the proper use and care of the PEG tube are provided. A well-maintained PEG tube can remain functional for 2-3 years.

As with any invasive procedure, percutaneous endoscopic gastrostomy may be associated with certain complications which include bleeding, infection, persistent leakage aspiration and damage to the stomach and intestines.

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