Gastrostomy, also known as percutaneous endoscopic gastrostomy or PEG, consists of placing a small flexible tube, known as a tube, from the skin, directly to the stomach, to allow feeding in cases where the oral route cannot be used.
Thus, the placement of a gastrostomy is usually used in cases of:
- Stroke; Cerebral hemorrhage; Cerebral palsy; Tumors in the throat; Amyotrophic lateral sclerosis; Severe difficulty in swallowing.
Some of these cases may be temporary, as in stroke situations, in which the person uses the gastrostomy until he is able to eat again, but in others it may be necessary to keep the tube for several years or even for a lifetime.
This technique can also be used temporarily after surgery, especially when it involves the digestive or respiratory system, for example.
9 steps to feed through the probe
Before feeding the person with a gastrostomy tube, it is very important to place them sitting or with the head of the bed elevated, in order to prevent food from rising from the stomach into the esophagus, causing a feeling of heartburn. Then, follow the step-by-step:
- Examine the tube to ensure that there are no kinks that could impede the passage of food; Close the tube, using the clip or bend the tip, so that air does not enter the tube; Open the probe cover and place the feeding syringe filled with 50 to 60 mL of water; Remove the clip or unfold the probe tip, always with the syringe inserted in the tube; Push the water slowly into the probe, but stop if pain or too much pressure appears, and notify the doctor or a nurse; Re-bend the probe tip or close the tube with the clip and then remove the syringe; Fill the syringe with the crushed food, in the amount of 50 to 60 mL; Repeat the steps to close the tube and place the syringe in the probe, taking care not to leave the tube open; Gently push the syringe plunger, slowly inserting the food into the stomach. Repeat the necessary times until administering the amount recommended by the nutritionist.
After administering all the food through the probe it is important to wash the syringe and fill it with 50 mL of water, putting it back through the probe to wash it and prevent the pieces of food from accumulating, blocking the tube.
This care is very similar to that of the nasogastric tube, so watch the video to see how to always keep the tube closed, preventing air from entering:
How should the food be
The food must always be well ground and also do not contain very large pieces, so it is recommended to strain the mixture before placing it in the syringe. The diet plan should always be guided by a nutritionist to ensure that there are no vitamin deficiencies and, therefore, after placing the tube, the doctor can refer to consultations with the nutritionist. Here are some suggestions for what the probe feed should look like.
Whenever it is necessary to administer medication, the tablet must be crushed well and mixed in the food or water to be administered. However, it is advised not to mix drugs in the same syringe, as some may be incompatible.
How to care for the gastrostomy wound
In the first 2 to 3 weeks, the gastrostomy wound is treated by a nurse at the hospital, as more care is needed to avoid infection and even constantly assess the site. However, after being discharged and returning home, it is necessary to maintain some care with the wound, to prevent the skin from becoming irritated and causing some type of discomfort.
The most important care is to keep the place always clean and dry and, therefore, it is advisable to wash the area at least once a day with warm water, clean gauze and neutral pH soap. But it is also important to avoid clothes that are too tight or to put creams with perfumes or chemicals on the spot.
When washing the wound area, one must also observe the skin to ensure that there are no signs of infection, such as redness, swelling or pain on touch, for example. If this happens, you should go to the hospital or inform the doctor.
