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HOW TO USE AND CARE FOR YOUR PEG TUBE

(EN - ENTERAL NUTRITION)
How to Use and Care for Your PEG Tube

WHAT YOU NEED TO KNOW:

What is a PEG tube? A percutaneous endoscopic gastrostomy (PEG) tube is a plastic tube that is put into your stomach through your skin. PEG tubes are most often used to give you food or liquids if you are not able to eat or drink. Medical formula, medicines, and water can be given through a PEG tube.


How do I use the PEG tube? Your healthcare provider will tell you when and how often to use your PEG tube for feedings. You may need a bolus, intermittent, or continuous feeding. A bolus feeding is when formula is give over a short period of time. An intermittent feeding is scheduled for certain times throughout the day. Continuous feedings run all the time. Ask your healthcare provider which method is best for you:

  • Use a feeding syringe. Connect the feeding syringe to the end of the PEG tube. Pour the correct amount of formula into the syringe. Hold the syringe up high. Formula will flow into the PEG tube. The syringe plunger may be used to gently push the last of the formula through the PEG tube.

  • Use a gravity drip bag. Connect the tubing from the gravity drip bag to the end of the PEG tube. Pour the formula into a gravity drip bag. Hang the bag on a medical pole, a hanger, or other device. Adjust the flow rate on the tubing according to your healthcare provider's instructions. Formula will flow into the PEG tube. Ask how long it should take to complete your feeding.

  • Use a feeding pump. You may use an electric pump to control the flow of the formula into your PEG tube. Your healthcare provider will teach you how to set up and use the pump.

How do I care for my PEG tube?

  • Always flush your PEG tube before and after each use. This helps prevent blockage from formula or medicine. Use at least 2 tablespoons (30 milliliters) of water to flush the tube. Follow directions for flushing your PEG tube.

  • If your PEG tube becomes clogged, try to unclog it as soon as you can. Flush your PEG tube with a 60 milliliter (mL) syringe filled with warm water. Never use a wire to unclog the tube. A wire can poke a hole in the tube. Your healthcare provider may have you use a special medicine or a plastic brush to help unclog your tube.

  • Check the PEG tube daily.
    • Check the length of the tube from the end to where it goes into your body. If it gets longer, it may be at risk for coming out. If it gets shorter, let your healthcare provider know right away.

    • Check the bumper (piece that goes around the tube, next to your skin). It should be snug against your skin. Tell your healthcare provider if the bumper seems too tight or too loose.

  • Use an alcohol pad to clean the end of your PEG tube. Do this before you connect tubing or a syringe to your PEG tube and after you remove it. When you disconnect tubing or a syringe from your PEG tube, do not let the end of the PEG tube touch anything.

How do I care for the skin around my PEG tube?

  • Do not remove the stitches or medical tape that hold your PEG tube in place when you first get it. Your healthcare provider will take them off once the skin around your tube heals. Leave clean bandages over the tube area for the first 24 hours after the tube is put in. You may not need to use bandages after 24 hours if the skin around the tube looks dry. Ask when you can shower or bathe.

  • Routine skin care:
    • Clean the skin around your tube 1 to 2 times each day. Ask your healthcare provider what you should use to clean your skin. Check for redness and swelling in the area where the tube goes into your body. Check for fluid draining from your stoma (the hole where the tube was put in).

    • Gently turn your tube daily after your stitches come out. This may decrease pressure on your skin under the bumper. It may also help prevent an infection.

    • Keep the skin around your PEG tube dry. This will help prevent skin irritation and infection.

  • Use topical medicines as directed. You may need to put antibiotic cream on the skin around your tube after you are done cleaning it.

What else do I need to know about a PEG tube?

  • You may need to keep track of how much formula and other liquids you have each day. You may also need to keep track of how much you urinate and how many times you have a bowel movement each day. Bring this record to your follow-up visits.

  • You may need to check your weight daily or weekly. Keep a record of your weights and bring it to your follow-up visits. Your healthcare provider may need to change your feedings if your weight changes too quickly.

  • Take your medicines as directed. Learn which of your medicines can be crushed, mixed with water, and given through the PEG tube. Certain medicines should not be crushed or may clog the PEG tube.

  • Go to all follow-up appointments. You may need to have blood tests and other tests when you see your healthcare provider.

When should I seek immediate care?

  • You start coughing or vomiting during or after a feeding.

  • You have severe abdominal pain.

  • Blood or tube feeding fluid leaks from the PEG tube site.

  • Your PEG tube is shorter than it was when it was put in.

  • Your PEG tube comes out.

  • Your mouth feels dry, your heart feels like it is beating too fast, or you feel weak.

When should I contact my healthcare provider?

  • You have nausea, diarrhea, or abdominal bloating or discomfort.

  • You have stomach pain after each feeding or when you move around.

  • You have discomfort or pain around your PEG tube site.

  • The skin around your PEG tube is red, swollen, or draining pus.

  • You weigh less than your healthcare provider says you should.

  • Your PEG tube is longer than it was when it was put in.

  • You have questions or concerns about your condition or care.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.