Do not drink anything starting 2 hours before your scheduled arrival time. This includes water. Things to remember This procedure uses an endoscope (flexible tube with a camera and light at the end) to insert the gastrostomy device. It is carried out by a surgeon in the operating theatre or a gastroenterologist in the gastroenterology investigation suite. The endoscope is passed into the mouth and down the food pipe to the stomach which is inflated with air to bring it closer to the surface of the abdomen.

Because of the extension tube needs to be repeatedly connected and disconnected -button PEG tends to wear out and needs replacement on a regular basis If you take medication to thin your blood, ask the doctor who prescribes it for you when to stop taking it. Some examples are warfarin (Coumadin®), dalteparin (Fragmin®), heparin, tinzaparin (Innohep®), enoxaparin (Lovenox®), clopidogrel (Plavix®), and cilostazol (Pletal®). Limb supports to assist with dressing are designed to provide dressing support to a person who has had an amputation. Your community dietitian will arrange further deliveries of feed and other equipment once you are at home.How you manage toileting is very personal and different for everyone. Most people want to be as independent as possible, minimising the risks of ‘accidents’ at any time. There are many recordable resources on the market such as Talking Postcards and Talking Pegs. Recordable buttons such as Talking Points offer many solutions to many classroom problems – the ten ideas below are tried and tested, though I’m sure you will come up with many more of your own! Here are my ten favourite ways to use this versatile resource: A GJ device is usually suggested after gastrostomy feeding has been unsuccessful. Some people cannot tolerate feeding directly into the stomach, so a GJ device can be helpful as it bypasses the stomach. A GJ device can be helpful for people with gastric motility problems, where food does not pass through the stomach to the intestines as it should. Insert the lubricated balloon PEG into the stoma gently and it should pass freely without much resistance

Your GP and Community Dietitian will be sent a letter informing them of the procedure you have had. We may give you a spare nasogastric tube or gastrostomy device to take home with you. If the device falls out, you will need to insert the spare tube or device into the opening straight away - otherwise, it will close. The nurse will advise you about when it is safe to do this. Blumenstein I, Shastri Y, and Stein J. Gastroenteric tube feeding: techniques, problems and solutions. World J of Gastroenterol. 2014;20(26):8505-24. This is granulation tissue and is common. Call your health care provider if the tissue bleeds, grows in size, or if fluid or pus leaks. Fluid leaks around the button:G-buttons need to be replaced for different reasons (balloon leaks, your child grows, etc.). We recommend changing them every four months and will show you how to do this. As many have a hook on the alternative end, they can also be used for reaching items of clothing, such as pants and trousers.

Wrap-around tops, cardigans and skirts may be easier, although you may need to be able to secure them at the waist. You may be able to adapt a belt by using hook and loop fastener, such as Velcro, or a large popper or magnetic button Scheduled replacements require no antibiotics and the tubes can be used immediately as long as no complications are suspected. Stoma tract measurement is required when initially replacing with a low-profile tube and can be estimated from the markings and fit of the existing tube. Dedicated stoma tract measuring devices will give more accurate measurements, remembering that the tract length may increase 0.5-1.0 cm when the patient goes from supine to upright position. 6 If the jejunal port is not being used, you should flush this more frequently, between six and twelve hourly.

You should flush the device as you have been shown before and after feeds and after giving medicines. Whatever your difficulty, you will need clothes that are easiest for you to manage when you want to use the toilet. Consider how you personally use and transfer on and off a toilet. Family Fundprovides grants for families raising disabled or seriously ill children and young people aged 0-18. They provide grants for a wide range of items, including clothing.

A special liquid feed containing all or most of the nutrients needed is used with the gastrostomy. There is no need to add flavouring to the feed as it is delivered directly into the stomach. Liquidised or pureed food should not be given through the gastrostomy. Some children can continue to eat regular food by mouth, using the gastrostomy to ‘top up’ their nutrient levels, but this depends on the reasons why the gastrostomy is required. Before the procedure it is important that your stomach is empty. Please do not eat or drink anything for at least six hours (preferably overnight) before the procedure.

Balloon PEGs

This method uses x-rays and other imaging techniques to insert the gastrostomy device. It is carried out by an interventional radiologist (doctor specialising in scans and imaging to perform procedures) in the Interventional Radiology department. As x-rays are used, children will need to have some barium the evening before the procedure. This usually comes as a milkshake or can be given down an NG tube – it travels through the digestive system to the large intestine so it can be seen clearly during the insertion procedure. PEG placement is generally a safe and well tolerated procedure. However, the following are potential risks: This consists of two plastic clips joined with a piece of elastic. One clip is attached to your top, the other to your trousers before you lower trousers to go to the toilet. This helps keep trousers within reach when you stand after using the toilet. The “Why” of PEG replacement can be divided into scheduled vs. unscheduled PEG replacement. Scheduled replacement occurs when the PEG is replaced before any significant deterioration or complication resulting in malfunction of the existing PEG has occurred. Scheduled PEG replacement is the preferred and most common form of PEG replacement (Table 1). Before going to the operating theatre, you will meet the doctor who will explain the operation in detail, discuss any worries you may have and ask you or your child to give permission for the operation by signing a consent form.