When individuals require long-term nutritional support, a medical device is often placed to deliver formula and medicine directly into the digestive system. This process is known as enteral feeding, and the tube used is frequently a gastrostomy tube (G-Tube). The terms G-Tube and Percutaneous Endoscopic Gastrostomy (PEG) tube are often used interchangeably, causing confusion. The distinction is straightforward: one term describes the device’s location and function, while the other refers specifically to the insertion procedure.
The Gastrostomy Tube: A General Overview
A Gastrostomy Tube, or G-Tube, is a hollow device inserted through the abdominal wall to create a direct passageway into the stomach. The term “gastrostomy” defines the anatomical location of the tube, which is the stomach. The primary purpose of a G-Tube is to provide long-term access for delivering nutrition, fluids, and medications when a person cannot safely consume them by mouth. These tubes can also be used for venting or decompressing the stomach to relieve gas or built-up fluid.
G-Tubes vary in physical design, including longer, visible tubes and low-profile devices often called “buttons.” Both styles are secured inside the stomach, typically using an inflated water balloon or a mushroom-shaped internal bumper. G-Tubes are generally used for conditions that impair swallowing, such as neurological disorders, or when a patient needs supplemental calories for an extended period.
The PEG Tube: A Specific Insertion Procedure
The term PEG Tube is an acronym for Percutaneous Endoscopic Gastrostomy, which describes the minimally invasive method used to place the device. “Percutaneous” means the procedure is performed directly through the skin, avoiding a large surgical incision. The “endoscopic” component refers to the use of a long, flexible camera, called an endoscope, which is passed through the mouth and into the stomach. This technique allows the physician to visualize the inside of the stomach while identifying the optimal insertion point on the abdominal wall.
The most common insertion method is the “pull” technique, where the endoscope helps snare a guide wire used to pull the PEG tube through the mouth and out through the abdominal wall incision. Because the procedure is guided by the endoscope, it is quicker and less invasive than traditional open surgery. A PEG tube is simply a G-Tube that was inserted using this specific endoscopic method.
Clarifying the Relationship: PEG Versus G-Tube
The distinction between the two terms is procedural versus general. A G-Tube is the overarching category for any tube that terminates in the stomach through the abdominal wall. Therefore, a PEG tube is always a Gastrostomy Tube, but a Gastrostomy Tube is not always a PEG tube.
G-Tubes can also be placed via open surgery, requiring a full incision, or through a Radiologically Inserted Gastrostomy (RIG). The RIG procedure uses X-ray or fluoroscopy imaging to guide the tube placement. Regardless of the method—endoscopic (PEG), surgical, or radiological (RIG)—the final device resting in the stomach is functionally a G-Tube. The procedural name, like PEG, only specifies the technique used to create the access tract, while G-Tube describes the device itself and its anatomical destination.
Living with a Gastrostomy Tube: Care and Function
Daily life with a Gastrostomy Tube, regardless of its placement method, centers on maintaining the integrity of the tube and the skin around it. The opening where the tube enters the body, known as the stoma, requires regular care to prevent infection and skin irritation. This includes cleaning the site one or two times a day with mild soap and water, then gently patting the area dry. Caregivers should look for signs of complications, such as increased redness, swelling, warmth, or a persistent discharge, which could indicate a local infection.
A frequent management task is flushing the tube, which involves pushing a small amount of water through the tube before and after each use. This action prevents the tube from clogging with formula or crushed medications, which is one of the most common issues. Leakage of stomach contents around the stoma is another concern that can cause skin breakdown, sometimes requiring a change in the tube’s size or type. If the tube accidentally comes out, it must be replaced quickly, as the stoma tract can begin to close within hours, necessitating immediate medical attention.