Percutaneous endoscopic gastrostomy (PEG) feeding.

Cite this as: BMJ 2010;340:c2414 doi: 10.1136/bmj.c2414 Percutaneous endoscopic gastrostomy (PEG) feeding, introduced into clinical practice in 1980, is now established as an effective way of providing enteral feeding to patients who have functionally normal gastrointestinal tracts but who cannot meet their nutritional needs because of inadequate oral intake. It is the preferred method of feeding when nutritional intake is likely to be inadequate for more than four to six weeks, and when enteral feeding is likely to prevent further weight loss, to correct nutritional deficiencies, and to stop the decline in quality of life in patients caused by insufficient nutritional intake. 4 The beneficial effects of gastrostomy feeding on morbidity and mortality have been described only in certain subgroups of patients. 6 Randomised studies in patients after stroke who received gastrostomy feeding have shown improved nutritional outcomes, higher likelihood of survival, and earlier discharge. 7 However, gastrostomy tubes are increasingly being requested and inserted for indications where long term outcomes are uncertain. In this review we discuss the indications for, controversies surrounding, and complications of gastrostomy feeding and provide practical advice on the management of percutaneous endoscopic gastrostomies.