Percutaneous Endoscopic Gastrostomy: What to Expect at Home

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Your Recovery

A percutaneous endoscopic gastrostomy (PEG) is a procedure to make an opening between the skin of your belly and your stomach. The doctor put a thin tube called a gastrostomy tube (G-tube or feeding tube) into your stomach through the opening. 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.

Your belly may feel sore, like you pulled a muscle, for several days. Your doctor will give you pain medicine for this. It will take about a week for the skin around your feeding tube to heal. You may have some yellowish mucus where the feeding tube comes out of your belly. This is normal and is not a sign of infection.

You will need to learn how to use and care for your feeding tube. Your doctor may recommend that you have a nurse or dietitian visit you at home to help you get started with your feeding tube. At first you may need a friend or family member to help you with your tube feedings. But with practise, you may be able to do it yourself.

This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to feel better as quickly as possible.

How can you care for yourself at home?

Activity

  • Rest when you feel tired. Getting enough sleep will help you recover.
  • Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
  • Ask your doctor when you can drive again.
  • Until your doctor says it is okay, avoid lifting anything that would make you strain. This may include heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, a vacuum cleaner, or a child.
  • You can shower as usual. Pat dry the skin around your feeding tube. Do not take a bath unless your doctor tells you it is okay.

Diet

  • Follow your doctor's instructions about eating and drinking.
  • Follow your doctor's instructions about what nutrition and fluids to feed through your tube.

Medicines

  • Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
  • 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 and when to start taking those medicines again. Make sure that you understand exactly what your doctor wants you to do.
  • If you take medicine through your feeding tube:
    • Follow exactly your doctor's instructions about how to do this. Do not try to put whole pills in your feeding tube. They may get stuck. Ask your doctor if liquid medicine is available.
    • Do not mix your medicine with tube-feeding formula. This can cause a clog in the feeding tube.
    • Do not put more than one medicine down your feeding tube at a time.
    • Flush the tube with water before and after you put each medicine down your tube.
  • Take pain medicines exactly as directed.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
    • Do not take two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.
  • If you think your pain medicine is making you sick to your stomach:
    • Take your pain medicine after meals (unless your doctor has told you not to).
    • Ask your doctor for a different pain medicine.
  • If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

  • Your doctor or nurse will show you how to care for the skin around the tube. Be sure to follow the instructions on keeping the area clean.
  • Wash the skin around your feeding tube daily with warm, soapy water, and pat it dry. Other cleaning products, such as hydrogen peroxide, can make the wound heal more slowly. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
  • Keep the area clean and dry.

Using your feeding tube

  • Follow your doctor's instructions about using the feeding tube. Your doctor or nurse will:
    • Tell you what to put through the tube.
    • Teach you how to watch for infection at the tube site or for a clog in the tube.
    • Tell you what activities you can do.
  • Keep your feeding tube clamped unless you are using it.
  • Keep the tube taped to your skin at all times, and leave some slack in the tube. This helps prevent pain and keeps the tube from coming out.
  • Wash your hands before you handle the tube and tube-feeding formula. Wash the top of the can of formula before you open it.
  • Keep the formula in the refrigerator after you open it. Do not let the formula sit at room temperature for more than 8 hours.
  • Sit up or keep your head up during the feeding and for 30 minutes after.
  • If you feel sick to your stomach or have stomach cramps during the tube feeding, slow the rate that the formula comes through the tube. Then gradually increase the rate as you can tolerate it.

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 or nurse call line 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.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You pass out (lose consciousness).
  • You have severe trouble breathing.
  • You have sudden chest pain and shortness of breath, or you cough up blood.
  • You have severe belly pain.

Call your doctor or nurse call line now or seek immediate medical care if:

  • You have pain that does not get better after you take pain medicine.
  • You have a fever over 38°C.
  • You have signs of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the area.
    • Pus draining from the area.
    • Swollen lymph nodes in your neck, armpits, or groin.
    • A fever.
  • The stitches that hold the feeding tube in place are loose or come out.
  • Your feeding tube comes out.
  • Your feeding tube is clogged, or liquid will not go down the tube.
  • You cough a lot or have other trouble during tube feedings.
  • You have nausea, vomiting, or diarrhea.

Watch closely for any changes in your health, and be sure to contact your doctor or nurse call line if:

  • You have any problems with your feeding tube.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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