Insertion of Feeding Tubes

Feeding Tubes (NG / PEG / PEJ)

Nutrition—the food we eat—is as important to our health as the air we breathe or the water we drink. When we are sick, nutrition is even more important. Some patients can’t eat and drink the food and water they need because of cancer, stroke, surgery, or other conditions. These patients must be fed through a feeding tube. There are several different kinds of feeding tubes and sites in the body where they can be placed.

Nasogastric (NG) Tube

One common kind of feeding tube is a nasogastric (NG) tube, so called because it enters through the nose (naso-) and its tip ends up in the stomach (-gastric). A nasogastric tube may not be best for patients who have problems swallowing or need to be fed by tube for an extended period of time due to long-term conditions. These patients are better fed through a gastrostomy tube, a tube that goes into the stomach directly through the skin. The gastrostomy tube is also known as a G-tube.

Percutaneous Endoscopic Gastrostomy (PEG) Tube

Percutaneous endoscopic gastrostomy (PEG) is a technique for placing a gastrostomy tube. Percutaneous simply means “through the skin’. An endoscope is a flexible tube with a light on the end that is used to place a PEG tube properly in the stomach. After the patient is sedated and the throat is numbed, the endoscope is gently passed through the patient’s mouth and into the stomach. The physician fills the stomach with air and can see exactly where to place the tube in the stomach. The endoscope does not interfere with -breathing. PEG requires only a small opening in the skin under local anesthesia (when just the skin is numbed).

Percutaneous Endoscopic Jejunostomy (PEJ) Tube

For some patients being fed liquid diets, it is better if the feeding goes directly to the intestine instead of through the stomach first. A tube, called a jejunostomy tube or j-tube, can be inserted into the gastrostomy tube and moved past the stomach into the top of the small intestine. This technique is just like PEG except that the end of the tube is positioned in the intestine instead of in the stomach. PEJ is used for patients whose stomach contents tend to flow back up into the esophagus (called gastroesophageal reflux).

How long a patient needs to be fed through a G-tube or a J-tube depends on the patient’s problems. Some patients may be tube fed for only a few months; others may receive their nourishment this way for years. For long-term patients, the tube might need to be replaced from time to time, depending on how carefully the tube is cared for. After the doctor puts in the first replacement tube, it’s easy to replace the tube.