PEG Placement

If you have diabetes, ask your regular doctor for diet and medication restrictions.
If you take a medication to thin your blood and have not already discussed this with our office, please call us at 612-871-1145.
If you take aspirin, you may continue to do so.
If you are or may be pregnant, please discuss the risks and benefits of this procedure with your doctor.
If you must cancel or reschedule your appointment, please call 612-871-1145 as soon as possible.

PREPARATION
To ensure a successful exam, please follow all instructions carefully.

Before your procedure:
Fill out the Health History form to bring with you on the day of your appointment.

1 day before your procedure:
• Do not eat solid foods after midnight.
• Clear liquids are permitted, such as water, clear broth and apple juice.
• Do not drink red liquids or alcoholic beverages.

The day of your procedure:
6 hours before your procedure:
• Discontinue clear liquids.

When you leave for the procedure:
• Bring a list of all of your current medications, including any allergy or over-the-counter medications.
• Bring medical records from any previous gastrointestinal surgeries, X-rays or procedures
• Bring a photo ID as well as up-to-date insurance information, such as your insurance card and any referral forms that might be required by your payer.
• Co-pays are required on the day of your appointment.
• Plan to spend at least one night at the hospital following your procedure for monitoring.

DESCRIPTION OF PEG PLACEMENT

What is PEG placement?
PEG (percutaneous endoscopic gastrostomy) is a procedure by which a feeding tube is placed to provide long-term nutritional support for patients who are unable to swallow as a result of head or neck tumors, trauma, stroke or other severe neurological problems.

What should I expect during PEG placement?
• The procedure itself takes about 30 minutes to complete.
• IV conscious sedation is used to help you relax for the procedure.
• A flexible tube called an endoscope is passed through your mouth into your stomach.  An endoscope allows the physician to see the inside of your esophagus and stomach.  It also helps locate the proper place in your stomach in which to position the feeding tube.  Once the best location has been determined, the skin is numbed, and a small incision is made into the abdomen through which a small tube is inserted.  This is the feeding tube.  The tube is held in place by a small button-like object called a bumper. It is now possible for formula, fluid, liquid dietary supplements, and if directed, medications to go through the tube directly into the stomach.
• Minor discomfort during the procedure may be felt, such as abdominal pressure or bloating

What should I expect after PEG placement?
• You will be looked after in the Endoscopy Department for a short period of time and will be admitted to the hospital for a day or two.  Usually, the tube feedings do not begin until the following morning. 
• The PEG tube does not prevent you from eating regular food.  The PEG tube provides an access, directly into your stomach, for extra nutrition if you are not able to take enough nutrition by mouth.
• The tube will only be in place as long as you need it to meet your nutritional needs.  Some people may need it for a short period of time and others may need to leave it in for their entire life.
• It is not uncommon to need to replace the tube from time to time if long term use is required. The tube can be easily removed when it is no longer needed.

What are the possible complications of PEG placement?
Although problems with PEG tubes are rare, it is important for you to know when to call the doctor.
 
Call if you have:
• Diarrhea for more than 48 hours
• Persistent nausea or vomiting, dehydration (symptoms:  thirst, dry tongue, fever, skin changes).
• Vomiting of feedings; bloating, or abdominal distention.
• Severe pain at tube site, a temperature over 101, or excessive drainage or bleeding from the site.
• If it is difficult or impossible to flush the tube with formula or water.

Support:
Your tube may be made by Bard Interventional Products or Wilson Cook.   Bard has a support number you can call anytime, day or night; 1-866-893-2691.  Wilson-Cook’s support number is 1-800-815-4707 and they are available 8am-5pm.   You may also call your physicians office.

12/21/2009