Patient education: Percutaneous endoscopic gastrostomy (PEG) – Discharge instructions (The Basics)

What are discharge instructions? — Discharge instructions are information about how to take care of yourself after getting medical care for a health problem.

What is percutaneous endoscopic gastrostomy? — Gastrostomy is a type of surgery that is done to put in a feeding tube. Feeding tubes are a way of getting the nutrients you need if you cannot get enough nutrition from eating and drinking by mouth.

"Percutaneous endoscopic gastrostomy" ("PEG") is a specific way of putting in a feeding tube. It involves using a tool called an "endoscope." An endoscope is a thin, flexible tube with a light and tiny camera on the end. It lets the doctor see inside the body. The endoscope goes into the mouth and esophagus, and then into the stomach. The camera on the end helps the doctor find the correct place to put in the feeding tube.

A feeding tube put in this way is called a "PEG tube." PEG tubes are a type of "gastrostomy tube" ("G tube") (figure 1).

PEG tubes are usually needed for people who will be unable to get enough nutrition from eating or drinking for 4 weeks or longer.

How do I care for myself at home? — Ask the doctor or nurse what you should do when you go home. Make sure that you understand exactly what you need to do to care for yourself. Ask questions if there is anything you do not understand.

Once you are home, you should:

●Take care of your incision:

•Keep your incision dry after surgery. Your doctor or nurse will tell you exactly how long to keep your incision dry. A bandage can be placed over the PEG tube's "bolster." (The bolster is the round piece on the outside of the body that holds the tube in place.) Do not put a bandage between the bolster and your skin.

•Once you no longer need to keep your incision dry, gently wash it with soap and water whenever you take a shower. (Your doctor or nurse will tell you when it's OK to start washing your incision.) Do not put your incision underwater, such as in a bath, pool, or lake. This can slow healing and raise your chance of getting an infection.

•After you wash your incision, pat it dry. Your doctor or nurse will tell you if you need to put an antibiotic ointment on it.

•Always wash your hands before and after you touch your incision or bandage.

●Make sure that you know how to take care of your PEG tube. Your doctor or nurse will show you how to do this. In general:

•Keep the skin around your PEG tube clean and dry.

•Wash your hands before and after touching the PEG tube.

•Clean the outside of the tube with soap and water. You can use a cotton swab to help with this.

•Do not put creams or powders around the PEG tube unless your doctor or nurse tells you to.

•Do not put bandages between the PEG tube's bolster and your skin.

•Your doctor or nurse will talk to you about how to flush the tube with water and how to feed yourself. Make sure that you understand their instructions. Ask questions about anything you do not understand.

●Take care of your mouth – Even if you don't eat or drink anything by mouth, it's still important to take care of your mouth and teeth. Brush 2 to 3 times a day, and floss regularly. You can also use mouthwash to freshen your mouth.

●Take all of your medicines as instructed.

●Increase your activity slowly – Your doctor or nurse will tell you exactly when you can do your usual daily activities again.

What follow-up care do I need? — The doctor will want to see you again after surgery to check on your progress. Go to these appointments.

You might need to talk with a dietitian to make sure that you are getting all of the calories and nutrition you need through your PEG tube. You might also work with a "home health agency" to help get your supplies and liquid food or formula.

When should I call the doctor? — Call for advice if:

●You have problems with your PEG tube, such as:

•The tube comes out.

•You cannot feed yourself through the tube.

•You cannot flush the tube with water.

•The skin around the tube is swollen, red, or hurts to touch.

•You see yellow, green, or bloody discharge in or around the tube opening.

•There is a bad smell coming from the tube.

●You have a fever of 100.4°F (38°C) or higher, or chills.

●You have redness or swelling around the incisions from your surgery.

●You have nausea or vomiting.

●You have hard stools or diarrhea, are not able to have a bowel movement, or are not able to pass gas.

●You have any symptoms that worry you.

More on this topic

Patient education: Percutaneous endoscopic gastrostomy (PEG) in adults (The Basics)
Patient education: Surgical gastrostomy (The Basics)
Patient education: How to care for a G tube or G button (The Basics)
Patient education: Enteral (tube) feeding (The Basics)
Patient education: How to give a tube feeding (The Basics)