Adults

Before the feeding tube is placed, an actual PEG tube or a picture will be shown to you, along with specific information about how the tube will be placed. You or your loved one may be in the hospital for a few days after the procedure. You’ll be told what to expect regarding a timeline when the procedure is scheduled.

Bathe the night or morning before the procedure. Don’t eat or drink anything for several hours before the procedure is scheduled. You’ll be told a specific number of hours to hold fluids and food the day before the procedure.

Your care team will talk about the tube and how it works, along with how to care for it.  This information will be given to you again after the procedure.

Expect the procedure to take one to three hours. Adults might receive anaesthesia for the procedure and will then be in the post-anaesthesia recovery area for a few hours.

The care team will closely monitor you or your loved one after the procedure, from anywhere from a few hours to 24 hours. Tube feeds will gradually be started a few hours after the placement of the PEG tube.

For the first two weeks after placement the stoma site should be cleaned daily using gauze and sterile water. Start near the stoma site and move outwards in circular motions. Do not adjust the retention disc that keeps the PEG tube in place.

Expect to see the first days after placement some drainage (clear or blood-tinged) at the site. Gently remove any residue. Be sure to thoroughly rinse and dry the area afterwards. Some redness after the procedure is normal and should go away in about three days.

After two weeks, the tube and stoma site can be cleaned with soap and water, rinse and dry the area afterwards. From that moment onwards the tube and disc need to be turned daily to make sure the skin doesn’t stick to it.

The gastrostomy tubing may pull to one side, and this may feel uncomfortable. Try looping the tubing in a gentle arch and then tape it to the abdomen. Sometimes a small roll of gauze near the stoma site can be used to rest the looped tubing on and then it can be taped in place. Try to not touch the tube very much, or if you’re the caregiver, monitor this activity to help prevent the tube from being pulled out.

Some pain medication might be given post-op, along with a prescription to take at home. Make sure the tube is flushed with water before and after the administration of medication.

Remember that oral care is still very important, even if food or medication is not taken orally. Frequent tooth brushing and rinsing your mouth several times a day is a good idea.

Before you leave the hospital, your care team will review instructions with you, including what supplies you’ll need or where you can get them, as well as how to your feeding supplies and when to call. Ask as many questions as you need to feel comfortable before leaving. They may schedule follow up appointments with you or discuss future tube options as low-profile tubes can replace PEG tubes 8-12 weeks after your procedures, based on how well your stoma heals.

You’ll want to find a good place to store supplies, tube feeds and enteral feeding pump.

When bathing, don’t fill the bath water above the level of the stoma until you’re told it’s safe to do that. Showering is also usually acceptable the day after the surgery.

Clean the site every day with soap and water, using a soft cloth or cotton applicator, and be sure to clean under the bolster as well. Expect some drainage to occur in the first few days, but also be on the lookout for major skin or stoma changes, as described by your care team. Wearing loose fitting clothes is recommended for added comfort.

If the retention disc feels too tight, talk with your doctor, as it can be loosened as weight gain occurs. You’ll need to rotate the tube daily.

If you use a feeding pump and bag, loop the extra tubing gently and tape the loop to prevent any accidental pulling on the stoma.

You’ll want to refer to your written directions for feeding instructions. This includes when to feed, what to feed, how much to feed, and pump-setting information if relevant.

Understand what requires urgent (within 24 hours) or emergent (immediate) care and never be afraid to call your care team with questions.

Remember: the first day at home after any big change is going to require some adjustment. But before long, you’ll become more used to the feeding tube and you’ll develop a new routine that’s second nature to you.