Percutaneous Endoscopic Gastrostomy (PEG) – Information and Care guidelines for patients and carers Once you have fully recovered from the anaesthetic (if you have had one) and are tolerating feeds well, you will be able to go home, unless any other procedures are planned. Usually, one or two nights’ stay in hospital is needed, depending on how well you get used to feeding through the device. Loose fitting, stretchy clothing without fastenings, such as T-shirts, will often be easier to manage and eliminates the need to fasten buttons or zips There are many recordable resources on the market such as Talking Postcards and Talking Pegs. Recordable buttons such as Talking Points offer many solutions to many classroom problems – the ten ideas below are tried and tested, though I’m sure you will come up with many more of your own! Here are my ten favourite ways to use this versatile resource: If you have difficulty managing or holding layers of clothing when you go to the toilet, consider alternative ways of temporarily securing your clothes. There is equipment for this (for example a Pants aid) but you may find it easier to sew discrete loops and buttons to hold layers out of the way

The initial gastrostomy device – except for the temporary Malecot® tube – usually needs to remain in place for at least six months for the opening to establish and can then stay in place for up to two years. After this, it will need replacing as the plastic will be starting to wear out and weaken. When a primary Mic-Key™ button has been in place for five months, or a PEG has been in place for around 18 months, call the team at GOSH to arrange an appointment to discuss the device change. Look at adapting the shape if necessary. Also keep fastenings within reach and use less fiddly designs, e.g. magnetic clasps or buttons.If you don’t have a responsible care partner to take you home, call one of the agencies below. They’ll send someone to go home with you. There’s a charge for this service, and you’ll need to provide transportation. It’s OK to use a taxi or car service, but you still need a responsible care partner with you. Agencies in New York

When feeds and fluids can be introduced will depend on the type of device that has been inserted and whether you previously had a gastrostomy: This consists of two plastic clips joined with a piece of elastic. One clip is attached to your top, the other to your trousers before you lower trousers to go to the toilet. This helps keep trousers within reach when you stand after using the toilet. There is always a small risk that it might be difficult to remove the existing gastrostomy tube if it has been in a while and has become well-attached to the inner stomach wall. Trying to remove the tube might damage the stomach wall, so if the doctors are not happy to continue trying, they might leave the gastrostomy tube in place and decide to remove it using another technique on another day.

Introduction to tube feedings

Add water if necessary. If the balloon leaks, the button needs to be replaced. (See the “Use and Care of a G-Button” brochure). As with all procedures, there is a very small chance that the planned method of insertion turns out to be unsuitable so an alternative approach will need to be considered. This may need to be done on a separate occasion. Your GP and Community Dietitian will be sent a letter informing them of the procedure you have had.

The percutaneous endoscopic gastrostomy (PEG) is the most common enteral feeding tube for long term nutrition support. Multiple guidelines and teaching materials are available for initial PEG placement. While this is beneficial for PEG placement, there is little evidence-based published literature to guide clinicians for PEG replacement. Rather than a “Willy-Nilly” approach, herein we combine the available evidence, published guidelines and expert opinion on PEG replacement. We review the why, when, what, who, and how of replacing PEGs with emphasis on practical clinical guidance. Optimal management of patients with PEG tubes necessarily requires expert PEG replacement practices to provide the best quality of life for these patients. INTRODUCTIONBefore the procedure it is important that your stomach is empty. Please do not eat or drink anything for at least six hours (preferably overnight) before the procedure. If you had a low profile balloon button GJ device inserted, you will usually be able to start using it for fluids and feeds straightaway Unlike gastrostomy tubes and buttons, GJ devices should not be rotated as this could move the position of the tube in the jejunum and cause kinks in the tubing.