PERCUTANEOUS ENDOSCOPIC GASTROSTOMY TUBE (PEG)

Transcription

1 PERCUTANEOUS ENDOSCOPIC GASTROSTOMY TUBE (PEG) Information Leaflet Your Health. Our Priority.

2 Page 2 of 6 This leaflet should only be used following assessment by a dietitian Introduction If you are struggling with your eating and drinking a feeding tube (PEG) may have been discussed with you. This leaflet will answer some of the questions you may have to help you to make your decision. What is a PEG Tube? A PEG tube is a feeding tube that is inserted into your stomach and through which liquid food is given. There are various medical reasons why you may need a PEG tube. They include: Difficulty swallowing food and/or liquids You are unable to eat enough to meet your needs You are unable to drink enough to meet your needs You may have a progressive illness which may lead to difficulty swallowing in the future In some cases the feeding tube may be temporary and can be removed if your condition improves and you are able to return to eating and drinking enough. How will having a PEG tube help me? A PEG tube can help you by: Allowing you to get all the nutrition and fluids that you need, giving you the balanced diet that you require. This may help you feel better and have more energy If mealtimes are a struggle and taking up more time than you would like, the additional liquid feed given via the PEG tube will remove this pressure. This means that you will be free to do the things that you would like to do If you have been having recurrent infections or choking a PEG tube will reduce this risk What are the risks of having a PEG tube placed? Placing a PEG tube is a comparatively safe procedure which means that it can be used for people who are elderly, frail, or ill for other reasons. However, as with most medical / surgical procedures, the placing of a PEG does carry some risks. These will be discussed with you by the doctor prior to the procedure. For some patients, particularly those with chest problems, the sedation can cause some problems although it is safer than having a general anaesthetic. All patients are monitored throughout the procedure to guard against problems arising from sedation Problems can also arise once the PEG tube is in position but these are seldom serious. For example, infection, leakage or overgrowth of skin as the site heals. With good hygiene and routine care these problems can be minimised

3 Page 3 of 6 Will I still be able to eat and drink? If your Speech and Language Therapist has advised you that it is safe for you to continue to eat and drink, then you will be able to do so as well as having liquid feed through the tube. Having a PEG tube will not prevent this or make it more difficult. Can I have a bath, shower or go swimming with a PEG tube in? Showering is a good way to keep the tube insertion site clean and you can have a shower soon after the PEG tube has been placed. Once healing is complete you will be able to have a bath as usual. Sitting in a bath of water increases the risk of cross infection and should be avoided for the first 2 3 weeks until the site has properly healed. How do I use the PEG tube to feed? The feeding option for you will be discussed with you. As much as possible this will be agreed with you to suit your life style. There are 2 methods of feeding: Pump feeding: This is delivered steadily over a period of time. The best/safest times will be discussed Bolus feeding: This means having your feeds at regular times through the day using a syringe Some people use a combination of both methods. Sometimes one method is safer for clinical reasons and this will be discussed with you. How do I look after my PEG tube? During your stay in hospital, you and / or your carers will be taught how to care for your tube. This will include: How you will care and clean your tube and skin How you will use the tube for your feed and medication What happens if I agree to a PEG tube being placed? If you agree to a PEG tube we will contact your Doctor and ask that a referral is made. The tube will be placed in the Endoscope Unit at the hospital. An appointment will be made for you. You will be advised of the date and of the period of time before hand when you should not eat or drink. You will need to stay in hospital for at least three days following the procedure. How is the PEG tube inserted? You will be given sedation through a needle in the back of your hand which will make you feel drowsy or sleepy. Once the sedation has taken effect, the endoscope will be passed down into your stomach, you will be given a numbing injection into the skin on your abdomen before a small cut is made to allow the tube to be passed through.

4 Page 4 of 6 You may be aware of the endoscope being passed and removed because this can cause some discomfort in your throat both during and after the procedure, but this should wear off quite quickly. You may be given a spray of medication before the procedure to lessen this discomfort. It usually takes between 15 and 20 minutes for the procedure to place the PEG tube and you will remain in the endoscope department until the effects of the sedation have worn off. What will happen immediately after the PEG tube is inserted? You will be taken to a ward and will stay in hospital for at least 3 days. While you are in hospital, the nurses will clean and care for your tube and insertion site. For the first few days after the tube has been placed, the site will be sore and there may be some local inflammation. This will be treated by the nursing staff and will usually clear up after a few days. You may need pain medication during this time. Once the site has healed it should be pain free. The hospital dietitian will devise a feeding plan with you which will take into account your individual needs. When you leave hospital you will be given an information pack including the names and telephone numbers of the community dietitian and nutrition nurse who will follow you up at home. How often does a PEG tube need to be replaced? The tube is made of long lasting polyurethane and normally will not need replacing for at least 2 years. Many tubes will last far longer than this with proper care. It is important to make sure that the tube does not become blocked and this can be avoided by flushing the tube with water before and after feed and medications. This advice will be written into your feeding regime by the dietitian. When the tube needs replacing or removing an appointment will be made for you to attend the Day Case Unit at the hospital. Do I have to decide about having a PEG tube now? Please feel free to talk this over with your family or carer, doctor, dietitian or speech and language therapist before you decide. Even if you do not feel ready to have a PEG tube at this time, at least you have some information on how it might benefit you in the future. If you would like to discuss this further, or would like to see a PEG tube, please contact your Dietitian who will be pleased to arrange to visit you. If your decision is to NOT have a tube, you will continue to be seen and supported by your dietitian and speech and language therapist as before.

5 Page 5 of 6 Contact us If you feel you need more help please contact your Dietitian/Nurse on the contact number below: Dietitians Selbourne House Union Street Hyde SK14 1NG Tel: The service is available: Monday Friday 8:30am 4:30pm Your Dietitian is: If you would like to make any suggestions or complaints please contact our Patient & Customer Services: Tel: Fax: pcs@stockport.nhs.uk Website:

6 Page 6 of 6 If you would like this leaflet in a different format, for example, in large print, or on audiotape, or for people with learning disabilities, please contact: Patient and Customer Services, Poplar Suite, Stepping Hill Hospital. Tel: PCS@stockport.nhs.uk. Our smoke free policy Smoking is not allowed anywhere on our sites. Please read our leaflet 'Policy on Smoke Free NHS Premises' to find out more. Leaflet number TG73 Publication date March 2016 Review date March 2017 Department Nutrition and Dietetics Location Tameside and Glossop