PEG feeding tube insertion (Percutaneous endoscopic gastrostomy (PEG))

What is a PEG feeding tube?

A PEG (percutaneous endoscopic gastrostomy) is a soft feeding tube that goes through the skin of the tummy directly into the stomach. It lets liquid feed, fluids and medicines be given when someone cannot eat or swallow safely, or cannot take in enough by mouth.

It is placed using a camera test. The endoscope lights up the stomach from inside so the team can find the safest spot, then a small opening is made through the skin and the tube is fed into place. A soft disc or balloon holds it on the inside, and a fitting holds it on the outside.

A PEG is usually considered for longer-term feeding — for example after a stroke that affects swallowing, in some neurological conditions, or during treatment for head and neck cancer. It is a supportive treatment that can help nutrition, hydration and medicines, but it does not treat the underlying illness and it does not always improve how someone feels overall.

Deciding to place a PEG is often a careful, shared decision, sometimes involving a feeding (nutrition) team, because the right answer depends on the person's wishes, their condition and what the tube can realistically achieve.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

PEG compared with a nasal (NG) feeding tube

An NG tube is often used first for short-term feeding. A PEG is considered when feeding is likely to be needed for weeks or longer.

Preparing for your procedure

• You will usually be asked not to eat for several hours beforehand; follow the exact fasting instructions given.
• Tell the team about blood-thinning medicines and any bleeding or clotting problems, as these need planning around the procedure.
• Mention diabetes, heart, lung or kidney problems and any allergies.
• Antibiotics are usually given just before the procedure to lower infection risk.
• Make sure the reasons for the PEG, the alternatives and the person's wishes have been discussed — for someone who cannot decide for themselves, a best-interests discussion should involve those close to them.
• Plan for training in tube and stoma care before going home, and arrange dietitian and community nurse support.

What happens

You usually have a local anaesthetic to the skin and sedation through a tube in your hand or arm; some people, and most children, have a general anaesthetic. Antibiotics are given to reduce infection risk.

The doctor passes an endoscope through your mouth into the stomach and inflates it gently with air. The light from the camera shows through the tummy wall, marking the safest place. After numbing the skin, a small cut is made and the feeding tube is fed into the stomach, held by a soft internal disc or balloon and a fitting on the outside.

The procedure usually takes around 20 to 45 minutes. Afterwards you rest while any sedation wears off. The tube can often be used for fluids and feed within a few hours, building up gradually under the dietitian's guidance, and the new opening (stoma) settles over the following weeks.

Is this procedure right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Comfort, sedation or contrast choices

If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.

Serious complications of the procedure itself are uncommon, but they do happen and can occasionally be severe. The most important thing to understand is that many people who need a PEG are already seriously unwell, so the weeks afterwards carry a real risk of becoming more poorly or dying from the underlying illness — not usually from the tube. This is one reason the decision should be made carefully, sometimes with a feeding team, and revisited if the person's condition changes.

Published figures to discuss

Serious complications of the procedure itself are uncommon, but death and serious illness in the weeks after a PEG are not rare — largely because of the conditions that lead to needing one, rather than the tube. UK studies show 30-day death rates after PEG vary widely with how unwell people are; careful patient selection and timing reduce avoidable harm. Rates below are cautious and from reviews and UK data, not guarantees.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

Recovery from the procedure itself is usually short, but how someone is afterwards depends mostly on their underlying condition. The new opening (stoma) takes a few weeks to settle, and feeding is built up gradually.

• Mild soreness and redness around the new opening for the first days
• A small amount of clear or slightly bloodstained leakage early on
• A sore throat and bloating after the camera test
• Granulation tissue (soft pink overgrowth) at the site that can be treated

Aftercare

• Clean and check the stoma site as you are shown, watching for signs of infection.
• Flush the tube before and after feeds and medicines to stop it blocking.
• Follow the dietitian's feeding plan and build feeds up as advised.
• Rotate or advance the tube only if your team tells you to, to help prevent buried bumper syndrome.
• Keep the community nurse and dietitian contacts to hand for problems.
• Know who to call urgently if the tube falls out, blocks, or the site becomes hot, painful or leaks a lot.

• Training in tube and stoma care completed
• Feeding plan from the dietitian
• Supplies of feed, syringes and dressings arranged
• Community nurse and dietitian contacts saved
• Plan for changing a balloon-type tube
• Clear note of warning signs and an out-of-hours number

Scars and how they heal

There is a small opening (stoma) in the tummy wall where the tube sits, not a surgical scar. If the tube is later removed, the opening usually closes over by itself in days to a few weeks, leaving a small mark.

⚠ Get urgent help if…

• Severe or worsening tummy pain, or a hard, swollen tummy
• A high temperature, shivering or feeling very unwell
• The site becoming hot, very red, swollen or leaking pus
• Feed or fluid leaking heavily around the tube
• The tube falling out or being pulled out (contact the team urgently — the opening can start to close)
• Vomiting, coughing or breathlessness during or after feeds (a possible sign of aspiration)
• Fresh bleeding from or around the tube

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

A working PEG means feed, fluids and medicines can be given reliably, which can support nutrition and ease the difficulty or risk of trying to swallow. The tube can usually be used within hours, with feeding built up over days.

A PEG supports nutrition but does not treat the underlying illness, and it cannot guarantee weight gain, longer life or better quality of life — these depend on the condition. For some people a PEG is clearly helpful; for others, especially when an illness is advanced, it may not change the outcome, which is why the decision is made carefully and reviewed.

A PEG can stay in for months or years. Standard tubes are often changed to a lower-profile balloon tube or button after the tract has matured, and balloon tubes are replaced periodically. The tube can be removed when it is no longer needed, after which the opening usually closes on its own.

Related tests, treatments or support

PEG feeding is usually part of wider care led by a nutrition or multidisciplinary team, alongside speech and language therapy (for swallowing), dietetics, and treatment of the underlying condition. A jejunal extension can be added if feeding into the stomach is not tolerated.

Follow-up & long-term care

You should have community dietitian and nursing support, a plan for changing the tube, and a named contact for problems. The need for the PEG should be reviewed over time, and it can be removed if it is no longer required or no longer in the person's best interests.

• Flush the tube regularly to prevent blockage.
• Keep the stoma clean and check it daily.
• Have balloon-type tubes changed on the schedule your team advises.
• Rotate or advance the tube as instructed to help prevent buried bumper syndrome.
• Keep supplies of feed, syringes and dressings stocked.

Repeat, follow-on and what comes next

• Tubes are often changed — for example from a standard PEG to a balloon tube or button — once the tract matures.
• Balloon tubes need periodic replacement.
• A tube that falls out is an urgent problem because the opening can start to close.
• The PEG can be removed when no longer needed, with the opening usually closing on its own.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• Hands-on training for the patient or carers in tube and stoma care before discharge.
• A dietitian-led feeding plan and supplies organised for home.
• A named community contact and clear urgent warning signs in writing.
• A plan and schedule for changing the tube.
• Review of whether the PEG is still needed and still in the person's best interests as their condition changes.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• Whether sedation or a general anaesthetic is used
• The endoscopist's fee and the facility or theatre charge
• The type of tube used (standard PEG, balloon/button, PEG-J)
• Antibiotics and any imaging used
• Length of any hospital stay
• Dietitian input and a community feeding plan
• Ongoing supplies of feed, syringes and dressings, and tube changes

• The endoscopist's fee and the facility fee
• Sedation or anaesthetist fees
• The cost of the tube and any later replacement
• Dietitian assessment and the feeding plan
• Arrangements and cost for community nursing and feed supplies
• What happens (and what it costs) if a complication occurs or the tube needs replacing
• Follow-up and review arrangements

On the NHS? PEG feeding is routinely provided on the NHS when clinically indicated; private access may be used for speed or convenience rather than because the NHS does not provide it.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the specialist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good specialist will welcome every one of these.

• What is the PEG expected to achieve for me, and what can it not do?
• Are there other options, such as a nasal tube or careful hand-feeding?
• Who will support tube and stoma care at home?
• How and when will the tube be changed?
• How will the decision be reviewed if my condition changes?
• What exactly should make me or my carers seek urgent help?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the specialist who carries out my procedure, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this procedure not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified specialist for peg feeding tube insertion

Every consultant is GMC-checked and independently reviewed. Search by postcode and distance, or switch to a map. Ordered by rating, relevance and recency — never by who pays.

How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: Patient.info (professional) — PEG feeding tubes NHS (St George's) — PEG insertion patient leaflet Improving 30-day mortality after PEG in England (national cohort) — GIE Death after PEG — NCEPOD national enquiry (PubMed) Buried bumper syndrome review — PMC

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.