Percutaneous endoscopic gastrostomy (PEG)

Percutaneous endoscopic gastrostomy, often called PEG, involves placing a small flexible tube that connects the stomach directly to the outside, through the abdominal wall. It allows nutrition, water and certain medicines to be given when the patient can no longer swallow properly or sufficiently over a long period. The procedure is carried out under sedation or anaesthesia. An endoscope is passed through the mouth into the stomach; its light, visible through the skin, helps choose the right puncture point. A small incision is made in the abdomen, and the tube is placed under camera guidance. It is held in place by a disc inside the stomach and another on the outside. Gastrostomy is offered when tube feeding is expected to last several weeks or longer: swallowing difficulties after a stroke, neurological disease, cancer of the throat or oesophagus, severe malnutrition. It is more comfortable than a tube passed through the nose and can be removed if swallowing returns to normal. The decision is made with the patient and their family. At Clinique Pasteur Tunis, percutaneous endoscopic gastrostomy is performed in the endoscopy suite by a gastroenterologist, with a short period of monitoring and training for the patient and those close to them in caring for the tube.