What is a gastrostomy?

A gastrostomy (literally, “an opening into the stomach”) is a procedure in which the doctor makes a direct opening through your abdominal wall and into your stomach, through which you can be fed directly into the stomach.

When is it used?

This procedure is done when you cannot swallow and need help with feeding. This can happen because you have cancer of the mouth or throat, after a stroke, or if you have developed another problem that makes it hard for you to swallow.

Most of the time a gastrostomy is a temporary measure, but sometimes it is permanent. It is more comfortable and less likely to clog up than a tube that goes through the nose and into the stomach.

What happens during the procedure?

The procedure can be done in one of two ways. The first and most common way is called percutaneous endoscopic gastrostomy (PEG). This is an outpatient procedure done using mild sedation and a local anesthetic. The doctor (surgeon or gastroenterologist) will guide a flexible endoscope through your mouth and down into your stomach. An endoscope is a long, narrow tube with a camera and light on the end of it. It lets your doctor look into the inside of your stomach. After the endoscope is in the stomach, your doctor will fill your stomach with air to make it bigger and push it up against your abdominal wall just below the ribs. After injecting a local anesthetic agent, he or she will make a small incision in the skin and guide a needle through your skin and abdominal wall and into your stomach. The doctor then will place a wire through the needle, retrieve it with the endoscope, and bring it out your mouth. The doctor will thread a tapered plastic tube over the wire and pull it through the small incision until it is in proper position. He or she will secure the tube in place with a small, adjustable silastic cross-bar.

The second way in which a gastrostomy is performed is called an “open” or surgical gastrostomy. This is done is you are unable to have an endoscope passed into your stomach safely. It is done in the operating room, usually under a general anesthetic, which puts you to sleep, relaxes your muscles, and keeps you from feeling pain. The surgeon will make a small incision in your upper abdominal wall and expose your stomach. Then he or she will place a tube through the skin and into the stomach. The surgeon will then sew up the incision on your abdominal wall and fix the tube to the skin.

What happens after the procedure?

If you have a percutaneous gastrostomy (PEG), the procedure is usually done as an outpatient. Once you have recovered from the sedation, you can go home. You can expect soreness at the site of the tube placement for a few days. You will be taught how to use and to care for the tube before the procedure. You can begin to use the tube for feeding after 12-24 hours.

If you have an open surgical gastrostomy, you will be taken back to your hospital room. You may stay in the hospital for 1 to 3 days, based on your condition. You may be fed directly into a vein for 1 or 2 days. Later, you will be fed by a nurse or instructed how to feed yourself through the gastrostomy tube and how to care for the tube.

What are the benefits of this procedure?

You will be able to use the tube for both food and medicine. It will help you get enough nutrition. It is more comfortable and easier to use than a feeding tube that goes through the nose and into the stomach.

What are the risks associated with this procedure?

• Infection or bleeding may occur.
• The tube must stay in place for about 2 months before it can be removed.
• You may need to have the tube changed periodically (every 6-12 months).
• The area around the tube may become infected after the operation. This can be treated easily without removing the tube.
• Rarely, you could leak stomach acid onto the skin or into the abdomen, requiring an operation to revise the tube.

You should ask your doctor how these risks apply to you.

When should I call the doctor?

Call the doctor immediately if:

• The tube comes or is accidentally pulled out, it must be replaced within a few hours.
• You find the tube is blocked and nothing goes through it.
• You are unable to take food through the tube.
• You have increasing pain near the tube, redness or swelling.

Call the doctor during office hours if:

• You have questions about the procedure or its result.
• You have a lot of drainage around the tube.
• The tube is getting old and needs replacement.
• You want to make another appointment.

Edited by Richard E. Burney, MD, UMHS General Surgery, November, 2005

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.