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Percutaneous Endoscopic Gastrostomy (PEG) Feeding Tube
MEDICAL ANIMATION TRANSCRIPT: Your doctor may perform a percutaneous endoscopic gastrostomy, or PEG, to insert a feeding tube into your stomach if you were unable to take food by mouth for an extended period of time. Digestion of food begins in the mouth. When you swallow, food is pushed down into your esophagus, a muscular tube that carries food to your stomach where it is digested. From the stomach, food travels to your small intestine, where digestion continues and nutrients are absorbed into the bloodstream. Your doctor may require a PEG feeding tube if you cannot eat, digest or absorb food due to esophageal cancer, oral surgery or stroke, major surgery, trauma, burns or anorexia, inflammation of the pancreas or radiation therapy, or inflammatory bowel disease affecting the small intestine. Before the procedure, you'll receive a sedative through an IV to help you relax. A local anesthetic will be administered at the site on your abdomen where the PEG tube is to be placed. The most commonly used PEG placement procedure is the Pull Method. During this procedure, your doctor will insert a lighted endoscope through your mouth and thread it down your esophagus and into your stomach. A camera attached to the endoscope will produce images of the inside of your stomach, which will be displayed on a video monitor. Next, your doctor will insert a needle through your skin into your stomach at the location where the PEG tube is to be placed. While doing this, he or she will use the endoscope to locate the end of the needle inside your stomach and encircle it with a wire snare. Your doctor will then pass a thin wire through this needle into your stomach, attach the endoscope to the wire, and pull both the endoscope and wire out through your mouth. At this point, there will be a thin wire entering the front of your abdomen into your stomach and continuing upward and out of your mouth. Your doctor will attach the PEG feeding tube to the wire outside of your mouth. By gently tugging on the other end of the wire, he or she will pull the tube back through your mouth and esophagus and into your stomach. Your doctor will continue to pull until the tip of the tube comes out of the incisions in your stomach and abdomen. A soft round bumper attached to the portion of the tube that remains inside the stomach secures it in place. The outer portion of the tube will be secured with a bumper as well, and sterile gauze will be placed around the incision site. In the alternative Push Method, your doctor will begin in the same fashion by using an endoscope to guide a wire through your abdominal wall and into your stomach. But instead of pulling the PEG tube through your mouth, he or she will push it directly into your stomach over the wire. After your procedure, you will continue to receive fluids through an IV for one to two days. Once there is evidence that your digestive tract is functioning, you will receive clear liquids through the PEG tube. If clear liquids are tolerated, you will receive a tube feeding formula through the PEG tube.