Looking after your percutaneous endoscopic gastrostomy tube (PEG)

What is a PEG?

A PEG is a soft tube placed through your skin into your stomach which allows food to enter directly.

The term ‘PEG’ describes the way it is placed:

Percutaneous – through the skin

Endoscopic – the equipment used to examine the stomach

Gastrostomy – opening into the stomach

Parts of the PEG:

• A clamp which allows the tube to be closed.
• A circular bumper that prevents the tube from falling out.
• A connector to attach syringes and giving sets to the tube.
• A triangular bumper on the outside which prevents the tube from sliding too far into the stomach.

What do I need to look out for?

You need to look at your site regularly to check for signs of infection. The things to look out for are:

• redness
• pain
• discharge which is yellow and smelly

If you notice these signs, contact GP, your company nurse or the nutrition nurse specialists.

It is also possible for the skin at the exit site to become pink and/or lumpy and it may bleed easily. This may be an overgrowth of tissue which can be easily treated with a special dressing or ointment. Again, contact your GP, company nurse or the nutrition nurse specialists if you are worried.

• Leaks of fluid around the tube
• Pain on feeding or flushing your tube
• New bleeding

If you have any of the above signs stop feeding immediately and telephone for urgent advice.

Monday to Friday 08:30 to 16:00 - nutrition nurse specialists

01223 216037

Out of hours – Please contact your GP or NHS 111

If you cannot wait to be seen by your GP, please contact your local hospital’s emergency department.

Why do I have a PEG?

You have this tube because you are unable to safely swallow enough food to keep you healthy. It provides a safe route for you to receive all the nutrients you require without choking on your food.

How long do I need to have my PEG?

Most people require a PEG long term as their swallow remains unsafe. You will, however, be regularly reviewed by a Dietitian to see how much food you require.

How long does my tube last for?

If it is well cared for, a tube can last for up to five years. You may require an endoscopy to replace your tube. Arrangements for this can be made by your GP or the nutrition nurse specialists.

One way of increasing the life of your tube is to leave the clamp undone when the end connector is in place. This prevents the clamp squashing the tube. You can also change the place the clamp sits along the tube to avoid squashing the same part of the tube each time.

How do I clean my PEG and the skin around it?

For the first week:

• Remove the dressing the day after your tube is inserted, this is no longer required. Clean the tube and site daily.
• Carefully clean under the outside bumper and around the site using neat Octenisan body wash, then cleanse with warm water and dry well.
• Apply the Bactroban / Naseptin ointment around where the tube exits the skin.
• It is important not to move the outside bumper for the first week as keeping it in place helps the site to heal.

After the first week:

• It is no longer necessary to use the Octenisan and Bactroban / Naseptin. Still clean daily with warm soapy water.
• You can now move the outside bumper along the tube to make cleaning the site easier. Make sure you replace the bumper approximately 2mm from the skin so that the tube does not slide in and out.
• Do not forget to clean the back of the bumper.

Can I have a bath? For the first two days after your tube is placed do not have a bath or shower, instead wash using the Octenisan body wash. For the rest of the first week you may have a shallow bath or a brief shower using the Octenisan body wash. Do not soak / immerse the tube and exit site. After the first week, if the skin around your site is clean and dry, you may return to your normal bathing routine. If you have any concerns please contact either your company nurse or the nutrition nurse specialists.

How do I manage my tube?

It is important to insert and rotate your tube once a week to stop the bumper in your stomach getting stuck. To do this, follow these instructions:

• Wash your hands with soapy water and dry well.
• Release the triangular bumper by opening the blue clip, remove the tube from the groove and slide back the triangular bumper away from the skin.
• Clean the tube, bumper (front and back) and stoma area with soapy water.
• Push two to four centimetres of the tube into the stomach and turn the tube in a complete circle with your fingers.
• Gently pull the tube back until resistance is felt.
• Place the triangular bumper back in its normal position, reinsert the tubing into the groove and close the fixation catch carefully.