Gastrostomy: Permanent and Temporary
Procedure
Definition
A gastrostomy makes a new path for food to enter the body. A tube is placed through the belly and into the stomach. It may only be needed until other areas heal, or it may be lasting. Gastrostomy can be done as an:
- Percutaneous endoscopic gastrostomy(PEG)—(more common)—uses a scope and a small cut in the belly
- Open procedure—a large cut is made in the belly
Reasons for Procedure
A gastrostomy is needed if food cannot pass through the mouth and throat. It may be needed to feed a person that has:
- A hard time swallowing
- Severe eating problems
- No ability to eat
It may also be used to drain a buildup of acid or fluids. This may be needed with blockages such as those caused by a cancer growth.
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Possible Complications
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Excess bleeding
- Problems from anesthesia
- Infection
- Aspiration—fluid, food, or foreign material gets sucked into the airways
- Injury to nearby structures or organs
- The tube moves or does not work properly
- Loose stools (poop)
Things that may raise the risk of problems are:
- Long-term diseases such as diabetes or obesity
- Smoking, drinking alcohol, or drug misuse
- Past surgeries in the belly area
What to Expect
Problems to Look Out For
Call your doctor if you are not getting better or you have:
- Signs of infection, such as fever and chills
- Redness, swelling, excess bleeding, or discharge from the cut
- The tube moves out of place, is clogged, or does not work well.
- Leaking of feedings around the tube site
- Cough, problems breathing, or chest pain
- Nausea or vomiting, or swelling in the belly
- Problems passing gas or stool (poop)
- Severe belly pain
If you think you have an emergency, call for medical help right away.
Prior to Procedure
The surgical team may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
- Fasting before surgery, such as avoiding food or drink after midnight the night before
- Whether you need a ride to and from surgery
Prior to Procedure
The surgical team may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
- Fasting before surgery, such as avoiding food or drink after midnight the night before
- Whether you need a ride to and from surgery
Anesthesia
The doctor will give general anesthesia. You will be asleep.
Description of the Procedure
A gastrostomy may be done at the same time as another stomach surgery.
Surgery may be done in one of two ways:
Open surgery—A cut will be made through the skin and the belly wall. The last cut will be made in the stomach. A tube will then be placed through the skin and into the stomach. This tube will be stitched in place. The cut will be closed with stitches or staples. A bandage will be placed over the site.
Percutaneous endoscopic gastrostomy (PEG)—Uses a small cut and a scope to place the tube and connect it to the stomach. A bandage is then placed over the cut.
How Long Will It Take?
At least 1 hour for open surgery. About 20 to 30 minutes for PEG surgery.
Will It Hurt?
The area will be painful after the surgery. Medicine and home care help.
Average Hospital Stay
The usual length of stay is 1 to 2 days. If there are problems you may need to stay longer.
Post-procedure Care
At the Hospital
After the procedure, the staff will:
- Give you IV nutrition for a few days.
- Show you how to use and care for the feeding tube.
During your stay, the hospital staff will take steps to lower your risk of infection, such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your cuts covered
During your stay you can also take steps to lower your risk of infection, such as:
- Washing your hands often and reminding visitors and staff to do the same
- Reminding staff to wear gloves or masks
- Keeping you cuts covered
At Home
Recovery takes a few weeks. Some activity may be limited at this time.
American College of Gastroenterology
American Society for Gastrointestinal Endoscopy
CANADIAN RESOURCES
Canadian Association of Gastroenterology
Health Canada
American College of Gastroenterology
American Society for Gastrointestinal Endoscopy
CANADIAN RESOURCES
Canadian Association of Gastroenterology
Health Canada
References
- Cyrany J, Rejchrt S, et al. Buried bumper syndrome: A complication of percutaneous endoscopic gastrostomy. World J Gastroenterol. 2016;22(2):618-27.
- Gastrostomy tube (g-tube). Kids Health—Nemours Foundation website. Available at: https://kidshealth.org/en/parents/g-tube.html.
- Gastrostomy tube (g-tube) home care. Cincinnati Children's website. Available at:https://www.cincinnatichildrens.org/health/g/g-tube-care.
- Gastrostomy tubes in adults in palliative care. EBSCO DynaMed website. Available at: https://www.dynamed.com/procedure/gastrostomy-tubes-in-adults-in-palliative-care.
- Percutaneous endoscopic gastrostomy (PEG). Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/treatments/4911-percutaneous-endoscopic-gastrostomy-peg.
Contributors
- Daniel A. Ostrovsky, MD
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