FEEDING TUBE PLACEMENTS
Percutaneous gastrostomy tube feeding
A percutaneous gastrostomy is a procedure done to place a PEG tube into the stomach through the abdominal wall to allow nutrition, fluids and medications to be put directly into the stomach, bypassing the mouth and oesophagus.
Why might gastrostomy tube feeding be needed?
Percutaneous gastrostomy is usually done for people who have difficulty swallowing (due to a condition like a stroke), appetite problems or are unable to get proper nutrition. It is also used for those who are sedated and unable to consume food. In this way, the natural digestive process is used, but only the mouth and oesophagus is bypassed.
How is a percutaneous gastrostomy placed?
This feeding tube may be placed using open surgery or endoscopic surgical techniques. When possible, Dr Mokhele will place it endoscopically as it is less invasive. This is known as a Percutaneous Endoscopic Gastrostomy (PEG). If this isn't possible, your gastroenterologist may refer you to a specialised surgeon to place the percutaneous gastrostomy tube.
Prior to the placement, your gastroenterologist will ensure that your stomach and bowels are empty. He will instruct you to stop eating any food 8 hours before and that you take a laxative to flush out the colon before your procedure.
A percutaneous gastrostomy tube is usually done in a theatre or day theatre on an outpatient basis. This means you will not need general anaesthesia, but you will be given a sedative to relax you. While the procedure won't be painful, it may be a bit uncomfortable. He will then ask that you lie on your side for the endoscopy. He will insert the thin endoscope fitted with a camera, into your mouth and ask that you swallow to allow it to move down through the oesophagus. With the help of the camera at the end of the endoscope, your gastroenterologist will be able to view the stomach lining and determine the insertion site for the tube. Dr Mokhele will then make an incision and pull the tube through the abdominal wall and secure it in place.
After the procedure, you will need to spend a night in the hospital for observation. You can expect some drainage from the tube site for the next two days. Mild bloating, gas and cramping afterwards are also all normal. With the help of Dr Mokhele and your dietician, you will be given support to the adjustment. With their help, you will be advised how to care for the percutaneous gastrostomy and the formula needed for the tube feeding. For most people, percutaneous gastrostomy tubes won't need replacing for the next 2-3 years. Any pain at the tube site, leakage of stomach contents around the tube site, and dislodgment or malfunction of the tube should be discussed with your doctor as they require immediate attention.
Gastrocure, Eastern Cape
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