Percutaneous Endoscopic Gastrostomy: Before Your Procedure

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What is a percutaneous endoscopic gastrostomy?

Percutaneous endoscopic gastrostomy (PEG) is a procedure to make an opening between the skin of your belly and your stomach. The doctor will put a thin tube called a gastrostomy tube into your stomach through the opening. This tube is sometimes called a G-tube or feeding tube. The tube can put liquid nutrition, fluid, and medicines directly into your stomach. The tube also may be used to drain liquid or air from the stomach.

You will get medicine to numb the back of your throat. You also will get medicine to make you sleep or feel relaxed. The medicine also prevents pain during the procedure. The doctor will put a thin, lighted tube that bends (called an endoscope, or scope) into your mouth. He or she will move the scope gently down your throat. The scope will have a camera on it. The doctor will look at a monitor (like a TV set or a computer screen) as he or she moves the scope into your stomach. The doctor will send puffs of air through the scope. This inflates your stomach. It helps the doctor see where to place the feeding tube.

The doctor will make a small cut in your belly. The cut is called an incision. The doctor will put the feeding tube into your mouth. Then he or she will guide the tube down your throat into your stomach. The doctor will pull one end of the feeding tube out of your belly through the incision. This end of the feeding tube will stay outside your body. The other end will stay in your stomach. The doctor may use stitches to close the incision around the feeding tube.

You will go home the same day as your procedure. Before you go home, your doctor or nurse will teach you how to use and care for your feeding tube.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What happens before the procedure?

Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your procedure.

Preparing for the procedure

  • Understand exactly what procedure is planned, along with the risks, benefits, and other options.
  • Tell your doctors ALL the medicines and natural health products you take. Some of these can increase the risk of bleeding or interact with anesthesia.
  • If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your procedure. Make sure that you understand exactly what your doctor wants you to do.
  • Your doctor will tell you which medicines to take or stop before your procedure. You may need to stop taking certain medicines a week or more before the procedure. So talk to your doctor as soon as you can.
  • If you have an advance care plan, let your doctor know. Bring a copy to the hospital. If you don't have one, you may want to prepare one. It lets your doctor and loved ones know your health care wishes. Doctors advise that everyone prepare these papers before any type of surgery or procedure.

What happens on the day of the procedure?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your procedure may be cancelled. If your doctor told you to take your medicines on the day of procedure, take them with only a sip of water.
  • Take a bath or shower before you come in for your procedure. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do not shave the surgical site yourself.
  • Take off all jewellery and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery centre

  • Bring a picture ID.
  • You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on.
  • The procedure will take about 30 minutes.
  • You will have a feeding tube coming out of the incision in your belly. You may have gauze around the incision. You may have a plastic bag attached to the end of your feeding tube. The bag will be removed before you go home.

Going home

  • Be sure you have someone to drive you home. Anesthesia and pain medicine make it unsafe for you to drive.
  • You will be given more specific instructions about recovering from your procedure. They will cover things like diet, wound care, follow-up care, driving, and getting back to your normal routine.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare for your procedure.
  • You become ill before the procedure (such as fever, flu, or a cold).
  • You need to reschedule or have changed your mind about having the procedure.

Where can you learn more?

Go to http://www.healthwise.net/ed

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