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Long-Term Peg Tube Feeding Guidelines

When an individual suffers a long- or short-term inability to take food in orally or in sufficient quantities to sustain life, a feeding tube offers an alternative. The surgical introduction of a percutaneous enteric gastrostomy (PEG) tube into the stomach provides a means for long-term nutritional support. There are advantages and concerns involved with PEG-tube use.

  1. Types

    • Some PEG tubes are flush with the skin surface and close with a flap seal. Other versions extend from the body and close with a clamp. Both types are unobtrusive under all but the tightest garments.

    Food

    • Achieve balanced nutrition through PEG-tube feedings by using medically approved prepared formula for meals. Properly diluted with sterile water, these formulas provide the nutrients and caloric intake necessary for the patient's well-being and hydration. Several formulas are commercially available in both canned and powdered versions. Canned formula offers the advantage of ease of administration and pre-measured meals. Powdered formula is lighter in weight, but must be measured and dissolved prior to use.

    Syringe Feedings

    • Use a 60 cc syringe to draw up diluted formula and inject it slowly and steadily into the PEG tube. Repeat this procedure until the full meal is delivered. Flush the tube with sterile water to clear the last of the formula.

    Gravity Feed Bag

    • Close the roller clamp on the gravity feed bag. Fill the bag with the liquid meal. Bleed all air from the drip line and attach the connector to the PEG tube. Open the roller clamp to allow the desired drip rate and monitor the meal. When the meal is completed, flush the PEG tube with a syringe of sterile water and close the tube. Some gravity feed bags require the use of an extender, a tube with a connector for the PEG tube.

    Schedule of Feedings

    • Confer with the physician as to the total food intake per day. Divide that intake total into several smaller feedings spaced throughout the day. Allow time for digestion between feedings to reduce the danger of regurgitation and discomfort to the patient.

    Skin Care

    • Clean the area around the PEG tube several times daily, using gentle soap and water. Gently rotate the PEG tube in the surgical opening--the stoma--periodically to reduce adhesion danger. Check with the physician for an appropriate topical conditioning cream to use, if needed. Granulation tissue may form at the stoma site, requiring outpatient surgical removal.

    Concerns

    • Avoid introducing air into the stomach through the PEG tube. The patient may complain of feeling bloated. Should this occur, open the PEG tube and allow excess air to escape. Assist the process by attaching an empty syringe to the PEG tube and drawing back excess air. Cleanliness is important in preparing and administering meals. Wash your hands before beginning any action concerning the PEG tube to avoid contamination problems.

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