Understanding Nutrition and What are the different types of pegs?

October 22, 2025 •

4 min read

According to the Cleveland Clinic, enteral nutrition is superior to total parenteral nutrition due to fewer infectious complications and reduced cost. For patients unable to meet their nutritional needs orally, this form of nutritional support is vital, making it important to understand what are the different types of pegs and other feeding devices.

Quick Summary

A comprehensive overview of the various types of feeding tubes used for enteral nutrition, including different gastrostomy, jejunostomy, and combination tubes, along with the criteria for their selection and use.

Key Points

PEG is a G-tube: A Percutaneous Endoscopic Gastrostomy (PEG) is a specific type of G-tube, inserted endoscopically into the stomach for long-term feeding.
Tube Location Dictates Function: The main differences among tubes like G-tubes, J-tubes, and GJ-tubes are where they terminate in the gastrointestinal tract, which determines their specific use cases.
Short-Term vs. Long-Term: Nasal tubes (NG, NJ) are for temporary use (less than 4-6 weeks), while surgically placed tubes (G, J, GJ) are for long-term nutritional support.
Feeding Method Varies: G-tubes can often accommodate larger bolus feedings, whereas J-tubes typically require slower, continuous feeding via a pump due to their location in the small intestine.
Role of the Dietitian: A dietitian is crucial for selecting the right formula, developing a feeding plan, and monitoring for complications in patients receiving enteral nutrition.
Low-Profile Options: For long-term comfort, many G-tubes and J-tubes can be replaced with low-profile 'button' devices after the initial placement site has healed.
Specialist Guidance is Key: The decision to use a particular type of feeding tube is a collaborative effort between the medical team, patient, and caregivers, based on a comprehensive health assessment.

Introduction to Enteral Nutrition and Feeding Tubes

For individuals with swallowing difficulties, head and neck cancers, or neurological disorders, receiving adequate nutrition orally is often not possible. Enteral nutrition, which delivers liquid formula directly into the stomach or small intestine via a feeding tube, is a critical solution. Among the various types of enteral feeding devices, 'pegs'—or Percutaneous Endoscopic Gastrostomy tubes—are commonly used for long-term feeding. However, it's essential to recognize that not all tubes are the same; the site of placement and method of insertion define the different types of feeding access.

Short-Term vs. Long-Term Feeding Tubes

Feeding tubes are broadly categorized based on their intended duration of use. Short-term tubes, typically used for less than 4 to 6 weeks, are inserted through the nose. In contrast, long-term tubes, which include the various types of 'pegs', are placed directly into the gastrointestinal tract through an incision in the abdomen. The following sections delve into these different classifications.

Nasal Feeding Tubes (Short-Term)

For temporary nutritional support, doctors may place a tube through the nose and down the esophagus. These tubes are flexible and are generally used when a patient is expected to regain the ability to eat orally within a few weeks.

Nasogastric (NG) Tube: A tube that goes from the nose into the stomach. It is suitable for patients with a functional stomach and low risk of aspiration.
Nasojejunal (NJ) Tube: This tube is longer, extending through the stomach and into the jejunum (the second part of the small intestine). It is used for patients with delayed gastric emptying or a higher risk of aspiration.

Surgically Placed Feeding Tubes (Long-Term)

When a patient needs nutritional support for more than several weeks, a surgically placed tube is a more comfortable and reliable option. These tubes are inserted through an opening, known as a stoma, in the abdominal wall.

Gastrostomy (G) Tube: Placed directly into the stomach. The G-tube is a foundational type of long-term feeding tube and is inserted surgically, endoscopically (as a PEG), or radiologically.
Percutaneous Endoscopic Gastrostomy (PEG) Tube: A type of G-tube inserted with the assistance of an endoscope. The procedure involves guiding the tube into the stomach through a small abdominal incision. The term 'peg' is often used generically to refer to any G-tube placed via this method.
Jejunostomy (J) Tube: This tube is inserted into the jejunum, bypassing the stomach entirely. It is indicated for patients with gastric intolerance, severe gastroesophageal reflux, or a gastric outlet obstruction.
Gastro-Jejunostomy (GJ) Tube: A combination tube with separate ports for the stomach and jejunum. The gastric port can be used to vent the stomach, while the jejunal port is used for feeding. It is particularly useful for patients with severe reflux who also need gastric decompression.

Comparison of Enteral Feeding Tubes

Choosing the right feeding tube is a decision made by a healthcare team based on a patient's medical condition, the duration of feeding, and the integrity of their gastrointestinal tract. Below is a table comparing the key characteristics of the main types of long-term feeding tubes.


Feature	Percutaneous Endoscopic Gastrostomy (PEG) Tube	Jejunostomy (J) Tube	Gastro-Jejunostomy (GJ) Tube
Placement Site	Stomach	Jejunum (small intestine)	Stomach and Jejunum
Best For	Long-term feeding for patients with functioning stomach and normal emptying.	Bypassing the stomach due to intolerance, reflux, or gastroparesis.	Patients requiring gastric decompression and intestinal feeding.
Feeding Method	Bolus feeding (mimics meals) or continuous pump feeding.	Requires slow, continuous feeding via a pump.	Continuous feeding via the jejunal port.
Key Advantage	Allows for more natural, intermittent feeding schedule.	Bypasses stomach issues, reducing aspiration risk.	Offers both feeding and gastric decompression through a single stoma.
Key Disadvantage	Higher aspiration risk for those with reflux or slow gastric emptying.	Continuous feeding is often required, limiting patient mobility.	Inner extension tube may migrate back into the stomach or become clogged.

Low-Profile (Button) Tubes

Both G-tubes and J-tubes can be replaced with low-profile button devices after the initial stoma has fully healed. These devices sit flush with the skin, making them less noticeable and easier to conceal under clothing.

Low-profile Gastrostomy Button: A button tube that connects directly to the stomach. An extension set is attached for feedings and medications.
Low-profile Gastro-Jejunostomy Button: A button tube with two ports, allowing access to both the stomach and the jejunum. It requires two separate extension sets.

The Importance of a Dietitian in Enteral Nutrition

Managing a diet with a feeding tube is a complex process that requires the expertise of a registered dietitian. A dietitian evaluates the patient's specific nutritional needs, considering factors like age, weight, health conditions, and activity level. They select the appropriate liquid formula, determine the feeding schedule, and monitor the patient's progress to prevent complications such as refeeding syndrome, dehydration, and electrolyte imbalances. They also provide crucial education on tube care, flushing, and troubleshooting, empowering patients and caregivers to manage home enteral nutrition safely and effectively.

Conclusion

Understanding what are the different types of pegs and other feeding tubes is essential for anyone involved in or considering enteral nutrition. From short-term nasal tubes like NG and NJ tubes to long-term abdominal tubes such as G-tubes, J-tubes, and GJ-tubes, the right choice depends on a detailed medical assessment. The percutaneous endoscopic gastrostomy (PEG) is a specific type of G-tube placement, often leading to confusion around the terminology. The choice between these devices is critical for ensuring effective and safe nutritional support. Regular consultation with a healthcare team, especially a dietitian, is vital for managing nutritional needs and minimizing complications associated with tube feeding, ensuring the best possible health outcomes. For further information, the Oley Foundation offers valuable resources on living with tube feeding.

Frequently Asked Questions

A Percutaneous Endoscopic Gastrostomy (PEG) is a type of G-tube, but not all G-tubes are PEGs. A G-tube is a broader term for any tube inserted into the stomach, while a PEG specifically refers to a G-tube placed using an endoscope.

A J-tube (jejunostomy) is used when the stomach is not suitable for feeding due to conditions like severe reflux, gastroparesis (slow stomach emptying), or a blockage. A J-tube delivers nutrition directly into the small intestine, bypassing the stomach.

It depends on the underlying reason for the tube placement and your healthcare provider's recommendations. In some cases, a person with a feeding tube may still be able to eat and drink small amounts, while others may have total restrictions.

A low-profile, or button, tube is a short, discreet feeding device that sits flush with the skin, replacing a longer, more visible tube. It requires an extension set to be attached for feeding and is typically used for long-term access after the initial stoma has healed.

Long-term feeding tubes like PEGs and J-tubes are designed to stay in place for months or years. They are replaced periodically, and the time frame depends on the type of tube and its condition.

Tube feedings can be administered in several ways, including bolus feeding (large amounts over a short time, mimicking meals), continuous feeding (steady drip via a pump over many hours), or a combination of both.

If a tube becomes clogged, it can sometimes be flushed with warm water using a syringe. If this doesn't work, medical attention is required. To prevent clogs, it's crucial to crush medications finely and flush the tube regularly.