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Gastroenterology

Percutan Endoscopic Gastrostomy (Peg)

Percutan Endoscopic Gastrostomy (PEG) is a minimally invasive procedure for inserting a feeding tube directly into the stomach through the abdominal wall. This method benefits patients unable to eat orally due to medical conditions like strokes, tumors, or neurological diseases. Turkey, renowned for its advanced healthcare facilities and skilled specialists, offers this treatment at affordable costs. Patients receive comprehensive care, including pre-procedure assessments and post-operative support, ensuring a safe and seamless recovery process.

What is Percutan Endoscopic Gastrostomy (PEG)?

Percutan Endoscopic Gastrostomy (PEG) is a widely used gastroenterology procedure to ensure nutritional support for patients unable to consume food orally. It involves placing a PEG feeding tube through the abdominal wall directly into the stomach, providing an effective and safe way to deliver essential nutrients.

  • Indications for PEG Tube Placement

    PEG is recommended for patients experiencing:

    • Difficulty swallowing due to neurological disorders like ALS or multiple sclerosis.
    • Obstructions in the esophagus caused by cancers or strictures.
    • Long-term inability to eat or drink post-surgery or severe injury.

Medical Conditions Requiring PEG

Common conditions necessitating PEG tube placement include:

  • Stroke Recovery: Preventing malnutrition in patients with impaired swallowing.
  • Head and Neck Tumors: Ensuring nutrition during chemotherapy or radiotherapy.
  • Chronic Neurological Diseases: Managing progressive conditions like Parkinson’s disease.

Comparison: PEG vs. Nasogastric Feeding Tubes

  • PEG Tubes: Long-term solution with minimal discomfort, securely placed via a minimally invasive procedure.
  • Nasogastric Tubes: Temporary feeding solution inserted through the nose, often uncomfortable and prone to dislodgement.
    PEG offers superior comfort and reliability for patients requiring sustained nutritional support.
Percutan Endoscopic Gastrostomy

How is PEG Performed?

PEG procedures are conducted with precision to minimize risks and ensure patient comfort.

  • Preoperative Preparations for PEG

    1. Medical Assessment: A thorough evaluation of the patient’s overall health, medical history, and current medications.
    2. Fasting: Patients are required to fast for 6–8 hours before the procedure.
    3. Consent and Planning: The procedure is explained, and informed consent is obtained from the patient or their guardian.

Step-by-Step PEG Procedure Overview

  1. Sedation and Preparation: Mild sedation or anesthesia is administered for patient comfort.
  2. Endoscope Insertion: A flexible tube with a camera (endoscope) is guided into the stomach via the mouth.
  3. Tube Placement: A small incision is made in the abdominal wall, and the PEG feeding tube is inserted.
  4. Secure Placement: The tube is anchored to prevent displacement, ensuring effective functionality.

Sedation and Anesthesia Considerations

  • Mild Sedation: Ensures comfort while allowing the patient to remain semi-conscious.
  • General Anesthesia: Used for patients with heightened anxiety or specific medical conditions requiring full sedation.

The procedure typically lasts 30–45 minutes and is followed by a brief observation period to monitor recovery.

Recovery and Aftercare for PEG Procedures

Recovery and maintenance are vital for the success of a Percutan Endoscopic Gastrostomy (PEG) procedure. Proper aftercare ensures the feeding tube remains functional and minimizes complications.

Immediate Aftercare Tips

  • Monitoring Post-Surgery:

    • Patients are observed for 24–48 hours to monitor for any signs of infection or discomfort.
    • Mild soreness or redness around the insertion site is common but temporary.

  • Feeding Initiation:

    • Feeding typically begins within 24 hours after the procedure, starting with liquid nutrition and gradually transitioning to prescribed formulas.

  • Hygiene Practices:

    • The incision site must be cleaned daily with sterile solutions to prevent infections.
    • Ensure the feeding tube is flushed with warm water before and after each use to avoid blockages.

Long-Term Maintenance of PEG Feeding Tubes

  • Routine Cleaning:

    • Regularly clean the external tube and surrounding skin to maintain hygiene.

  • Tube Functionality Checks:

    • Monitor the tube for signs of clogging or leakage.
    • Replace the tube as recommended by your doctor, typically every 6–12 months.

  • Nutritional Adjustments:

    • Work with a dietitian to customize the feeding formula based on the patient’s changing nutritional needs.

Common Challenges and Solutions in PEG Aftercare

  • Tube Dislodgement:
    • Solution: Seek immediate medical assistance for re-insertion.
  • Skin Irritation:
    • Solution: Apply doctor-recommended topical ointments and maintain strict hygiene.
  • Blockages in the Tube:
    • Solution: Flush the tube with warm water; persistent issues may require medical attention.

Frequently Asked Questions

1. Is PEG Surgery Painful?

The procedure is minimally invasive and performed under sedation or anesthesia, ensuring the patient feels no pain. Post-procedure soreness is mild and typically subsides within a few days.

2. How Long Does It Take to Recover from a PEG Procedure?

Most patients recover within 1–2 days, with feeding initiated 24 hours post-procedure. Complete healing of the insertion site may take 7–10 days.

3. Are There Risks Associated with PEG Tube Placement?

While PEG is generally safe, potential risks include:
  • Infection at the insertion site.
  • Blockages or dislodgement of the feeding tube.
  • Minor bleeding or irritation.
These risks can be minimized by following proper aftercare guidelines and choosing an experienced specialist.

The indicated treatments are performed in the hospitals that we have agreements with.

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