PEG/PEJ Tubes

Overview

A Percutaneous Endoscopic Gastrostomy (or Percutaneous Endoscopic Jejunostomy) tube is a tube that is surgically placed into the stomach or small intestine through a small hole in the skin. You will be given a general anesthetic and while you are deep asleep, the surgeon will make a small incision in your abdomen. A small, flexible, hollow tube, called a catheter, with a balloon or flared tip is inserted into your stomach (or small intestine for the jejunostomy) and then the tube is stitched into place.

While you recuperate, you will have to feed yourself and take your oral medications through either a gastrostomy (PEG) or a jejunostomy (PEJ) tube that will be placed in your abdomen during surgery. The procedures for cleaning the area around these tubes and using them are the same, and can be done very easily at home.

The tube itself will not hurt, but the area around the tube will be tender for the first few days. You may also feel a cool or warm sensation, depending on the temperature of the food/liquid or medication going through the tube.

Daily Care

• Always wash your hands with liquid soap and water for 1-2 minutes before takin care of your tube or starting the feeding.
• Cleanse around the tube with soap and water every day and as needed
• Turn flage ¼ turn each day
• Flush tube with 30cc of tap water twice a day, or after each feed
• Apply antibiotic ointment around the tube, only if your doctor orders
• Apply a dry, sterile dressing over the insertion site every day for 1 week, then remove

Feeding

• Any food that can be blenderized into a thin consistency can be used.
• Use juice, water or milk to thin food so it will go through the tube easily.
• Follow the same procedure for medications, but mix medications with water only.
• When using the tube, you should be in a semi-sitting or sitting position. Remain in that position for 30 to 45 minutes after the feeding or taking medication.
• Fill the syringe with food/liquid or medication and hold it approximately 8" high.
• Unclamp the tube and allow the syringe to empty slowly by gravity.
• Take your time and refill as necessary.
• If there is resistance or the liquid does not go in, use a small amount of Coca Cola® to help clear the tube.
• If you have a cuffed tracheostomy tube, inflate the cuff to open the tube before eeding or tak­ing medication, and keep it inflated for at least 30 minutes afterwards, unless you receive other instructions from your doctor.
• When finished, rinse the tube with water, remove the syringe and clamp the tube.
• Rinse out the syringe with water and store in a clean area.

Cleaning Supplies

• a plastic bag
• cotton swabs
• warm water
• a small towel
• tape (paper or silk)
• hydrogen peroxide
• sterile 4x4 gauze pads (split and non-split types)

Cleaning Procedure

1. Wash your hands thoroughly to help prevent infection.
2. Remove old dressing, place it into the plastic bag, seal the bag, and discard
3. Pour warm water a cotton swab. Clean the area around the tube in a circular pattern, moving away from the tube.
4. If there is crusty material or dried blood on the area around the tube, use another cotton swab mostened wtih hydrogen peroxide to clean the area. Pour warm water onto a clean cotton swab to rinse off the hydrogen peroxide.
5. Dry the area completely with small towel or a 4x4 gauze pad.
6. Apply a split sterile 4x4 gauze pad under the plastic triangle attached to the tube and tape in place. (The stitches will stay in place for 21 days and the site may be tender. Take your time.)
7. Loop excess tubing and tape to skin to prevent the tubing from pulling.

Call Your Doctor If….

·       You have bleeding

• You have unusual redness/warmth around the tube site
• You have pain at the site of the tube
• If the tube is plugged
• You have unusual drainage that is thick, foul-semlling or yellow-green in color
• If the tube seems to be moving out from the skin or if the tube falls out.
• You have diarrhea

Questions or Concerns

If you have any questions or concerns during office hours, please contact your doctor.

For questions during weekends, nights and holidays call the switchboard at 845-2300 and we will locate your physician.

Follow Up Appointment

Your follow-up appointment in the GI Center is scheduled for:

________________ @  _______ a.m. p.m. in the GI Center

[You can print this page and keep a record with the instructions.]