Stephen J. Schueler, M.D.

Overview Home Care warning signs

PEG Tubes Home Care

Nurses, who are specially trained in ostomy care, train patients who need to care for them. Basic ostomy training includes information on diet, stoma cleaning, PEG tube care, and management of various problems.

PEG tubes must be carefully managed in the first week after the surgery, as the stoma edges heal. The stoma must be kept clean and covered with gauze. If the tube pulls away from the abdominal wall, fluid may leak from the stoma. Leakage may also occur if the stoma is stretched. Tension on the PEG tube may cause the tube to be pulled out prematurely.

Feeding:

  • Wash your hands with soap and water before preparing the feeding or touching the PEG tube.
  • The patient should be upright during feeding and for sixty minutes after feeding, in order to reduce the risk of aspiration.
  • The feeding should be administered slowly, as directed by the doctor.
  • The tube should be flushed with water before and after feedings, or every 4 to 8 hours during continuous feedings.

Stoma Skin Problems
Skin irritation may occur from allergic reactions, minor skin infection, and skin irritation due to leakage. When skin irritation occurs, gently clean the surrounding skin. Let the skin dry and sprinkle ostomy skin powder on the irritated areas. Remove excess powder by dusting or blotting the area with a dry cloth.

Minor Bleeding
Bleeding from the exposed stoma is usually caused by small, irritated blood vessels. No treatment is needed for minor bleeding. However, bleeding from inside of the stomach requires immediate care.

PEG Tubes Warning Signs

If you have a PEG tube, notify your doctor for any of the following:

  • Abdominal swelling
  • Mild pain during feedings
  • Episodes of mild bleeding from the stoma
  • Obstructed PEG tube
  • Occasional vomiting after feedings
  • Redness or swelling of the skin around the stoma
  • Skin around the stoma becomes black

If you have a PEG tube, notify your doctor immediately for any of the following:
  • Black or brown material that looks like coffee grounds leaking from the stoma
  • Broken PEG tube
  • Moderate to severe abdominal pain after feeding
  • Moderate to severe bleeding from the stoma
  • Moderate to severe redness, swelling or pain around the stoma
  • PEG tube comes out
  • Pus draining from the stoma
  • Repeated vomiting after feeding

Last Updated: Mar 2, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed PEG Tubes References
  1. Gallagher H. Follow up after PEG tube insertion. Ulster Med J. 2007 Sep;76(3):171; author reply 171-2. [17853648]
  2. Sanders DS, Carter MJ, D'Silva J, McAlindon ME, Willemse PJ, Bardham KD. Percutaneous endoscopic gastrostomy: a prospective analysis of hospital support required and complications following discharge to the community. Eur J Clin Nutr. 2001 Jul;55(7):610-4. [11464235]
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