Let’s Talk Lingo
Artwork: “Familiar Objects” by Kathryn Lean
Psst… is that really a PEG? Children’s Nursing Queensland founders Natalie Gentile and Lisa Gyselman help us get tube-feeding fluent.
As stomal therapists and paediatric nurses, we have lots of success managing leaking devices, healing broken skin, recommending products and ensuring correct sizing of tube-feeding devices. However, we regularly have issues knowing if our clients really have a PEG, or not!
“PEG” is a term often used to describe all feeding buttons when in reality, it describes only one way of inserting a feeding tube.
We’ve put together a short, non- exhaustive list of tube-feeding terms which may help with a more accurate description of what you or your child has. Here goes:
Percutaneous endoscopic gastrostomy (PEG)
A method of insertion for a gastric feeding tube into the stomach. It’s often performed by a gastroenterologist in a two-step procedure and involves inserting a feeding tube endoscopically (through the mouth). The tube is then pulled out of a hole (stoma) that is made in the stomach.
Surgical gastrostomy
A laparoscopic surgical approach (often keyhole surgery) to insert a gastric feeding tube into the stomach. The stomach is brought up to the abdominal wall and sutured in place to create a stoma. A low-profile device is placed in the stoma for feeding.
Nasogastric tube (NG or NGT)
A thin tube is placed through the nose, down the oesophagus and into the stomach for feeding. The tube is taped in place on the face.
Jejunostomy (Jej or J)
A laparoscopic surgical approach (often keyhole surgery) to insert a gastric feeding tube into the jejunum (part of the bowel). The jejunum is brought up to the abdominal wall and sutured in place to create a stoma. A low-profile device or longer tube is placed in the stoma for feeding.
Gastrojejunostomy (GJ)
An endoscopic procedure to insert a feeding tube into the stomach that also has a longer ‘tail’ that passes into the jejunum (part of the bowel).
The double access points allow for a combination of stomach and jejunal feeding or medication administration. The device often requires a general anaesthetic for placement or changing.
So, why does it matter what we call them?
They do the same thing… right? Well, they are all designed to deliver nutrition to the body, but their use and care can be very different.
Providing incorrect care of the device, due to misunderstanding the procedure used to insert the tube, can cause big issues. This is particularly true for the post-operative period and through the first six months after the initial procedure.
Someone describing a jejunostomy as a “PEG” increases the risk of feeding issues – and the stoma itself is likely to be prone to different complications. A PEG is more likely to experience things like buried bumper syndrome or hypergranulation, while laparoscopic gastrostomies generally have a higher risk of mucosal prolapse.
It can be hard to get the terminology right – especially when clinicians get it wrong, too. But in the spirit of promoting safe care, we’d strongly suggest getting familiar with – and fluent in – your or your loved one’s feeding tube.