Tube Feeding: Techniques and Procedure

Percutaneous endoscopic gastrostomy (PEG) is the preferred route of feeding and nutritional support in patients with a functional gastrointestinal (GI) system who require long-term enteral nutrition. Enteral nutrition is the preferred means of nutrient delivery over parenteral nutrition for a functional GI tract. Enteral access can be achieved by various techniques. Percutaneous endoscopic gastrostomy (PEG) is now the technique of choice for long-term enteral feeding. The technique of PEG offers a superior access to the gastrointestinal system over surgical methods. PEG tube placement is one of the most common endoscopic procedures performed worldwide. The technique involves placement of a gastrostomy tube at a point where the stomach and abdominal wall are in closest contact. PEG is a bedside procedure not requiring general anesthesia. Feeding can begin within 24 h of placement. Major complications (peritonitis, bleeding, perforation, and pulmonary aspiration) occur infrequently. PEG feeding does not improve functional status of patients, nutritional status, life expectancy, or quality of life in patients with dementia. Selection of patients for PEG is best done utilizing a multidisciplinary team approach.