Percutaneous endoscopic gastrostomy

A percutaneous endoscopic gastrostomy (PEG) is a feeding tube placed through the wall of the abdomen directly into the stomach. It is a minor surgical procedure and is inserted using gastroscopy. This allows the mouth and oesophagus to be bypassed and assists with feeding in individuals where swallowing is a problem.

Indications for the insertion of a PEG include conditions which affect or prevent normal swallowing, amongst others:

  • Neurological disorders preventing normal oropharyngeal swallowing
  • Stroke
  • Degenerative neurological disorders
  • Prolonged ICU admission
  • Surgery to the head and neck

The procedure has significant risks and so there should be good reason to perform it. Preferably a speech therapist and dietician should be involved in the management of and decision-making regarding placement of a PEG. The PEG should be managed in conjunction with a specialist familiar with their use.


  • Sedation-related complications during the placement of the PEG, including respiratory suppression and aspiration.
  • Hypostatic or aspiration pneumonia - Chest physiotherapy post-procedure is important to prevent these.
  • Infection at the PEG site.
  • Bleeding from the PEG site.
  • Displacement of the PEG intra-peritoneally - Feeds may leak into the abdominal cavity in this situation, and it may be life-threatening.
  • Necrosis of the abdominal wall or stomach wall due to excessive traction on the PEG.