Why Would Someone Have a PEG Feed? Key Reasons and Indications

October 31, 2025 •

3 min read

Percutaneous endoscopic gastrostomy (PEG) procedures have become increasingly common for patients needing long-term nutritional support. A PEG feed provides vital nutrition to individuals who cannot ingest adequate calories or fluids orally due to various medical conditions, including difficulty swallowing (dysphagia), critical illness, or certain forms of cancer.

Quick Summary

A PEG feed provides vital nutritional support for people unable to swallow or absorb enough nutrients orally. Common reasons include neurological conditions, head and neck cancers, and critical illnesses requiring extended enteral feeding.

Key Points

Addressing Swallowing Difficulties: Many neurological disorders (stroke, MND, MS) and head/neck cancers cause dysphagia, making a PEG necessary for safe feeding.
Long-Term Nutritional Support: A PEG is often chosen for individuals requiring enteral nutrition for more than 30 days, offering a more comfortable and stable alternative to a temporary nasogastric tube.
Diverse Medical Applications: Beyond swallowing problems, PEG feeds are used for critical illness, trauma, gastrointestinal issues, and other conditions that impair oral intake.
Minimally Invasive Procedure: PEG tube insertion is a relatively quick, safe, and minimally invasive endoscopic procedure, typically performed with sedation.
Maintains Nutritional Status: By providing a reliable route for nutrition and hydration, a PEG can prevent malnutrition and help manage a patient's overall health.
Reduces Risk of Complications: A PEG is associated with a lower risk of aspiration and dislodgement compared to an NG tube, particularly for long-term feeding.
Can Be Temporary or Permanent: The tube can be removed if the patient's condition improves and they regain the ability to eat and drink orally.

A percutaneous endoscopic gastrostomy (PEG) tube is a feeding tube inserted through the skin directly into the stomach, used for long-term access for nutrition, fluids, and medication when oral intake is compromised. It is often preferred over temporary methods like nasogastric (NG) tubes for needs exceeding 30 days due to comfort and stability. The decision for a PEG involves the patient, family, and healthcare team.

Key Medical Conditions Requiring a PEG Feed

Conditions necessitating a PEG feed often impair swallowing (dysphagia) or prevent adequate oral nutrition. These include neurological disorders, head and neck cancers, and other systemic conditions.

Neurological Disorders

Neurological issues commonly affect swallowing muscles and nerves.

Stroke: Can damage brain regions controlling swallowing, with a PEG potentially providing temporary support during rehabilitation.
Motor Neurone Disease (MND) / Amyotrophic Lateral Sclerosis (ALS): Progressive muscle weakening affects swallowing over time, making a PEG vital for nutrition.
Parkinson's Disease, Multiple Sclerosis (MS): These conditions can also cause swallowing difficulties requiring a PEG.
Traumatic Brain Injury and Prolonged Coma: Patients unable to eat due to severe injury or coma require PEG feeding for survival.

Head and Neck Cancers

Cancers or their treatments can obstruct food passage or make swallowing painful.

Tumor Obstruction: Cancers of the esophagus, mouth, or throat can block food.
Treatment Side Effects: Radiation and chemotherapy can cause inflammation, making swallowing difficult. A PEG may be placed preventatively for continuous support.

Gastrointestinal and Other Conditions

Conditions like severe Crohn's disease, cystic fibrosis, and chronic malnutrition can require PEG feeding to improve nutritional status. For advanced dementia, PEG feeding is generally not recommended due to limited evidence of benefit.

The PEG vs. NG Tube: A Comparison

For enteral nutrition, PEG and NG tubes are options, with the choice depending on the duration of need.


Feature	Percutaneous Endoscopic Gastrostomy (PEG)	Nasogastric (NG) Tube
Insertion	Through abdominal wall into stomach.	Through nose into stomach.
Duration	Long-term (> 30 days).	Short-term (< 30 days).
Comfort	More comfortable for long-term use.	Can be irritating for extended periods.
Risk of Dislodgement	Less likely due to securing bumpers.	Higher risk of accidental removal.
Risk of Aspiration	Lowers risk, especially with poor gag reflexes.	Greater risk of aspiration.
Tube Diameter	Wider, less prone to blockage.	Smaller, more prone to clogging.

Benefits and Considerations of PEG Feeding

A PEG feed offers significant benefits, particularly for long-term needs.

Improved Nutritional Status

A PEG ensures sufficient nutrition and hydration, preventing weight loss and dehydration. It also simplifies liquid medication administration.

Quality of Life and Comfort

For long-term support, a PEG is often more comfortable and less conspicuous than an NG tube, improving quality of life and social confidence.

The PEG Procedure and Post-Care

Placement of the PEG Tube The procedure is minimally invasive. It involves sedation, local anesthetic, and using an endoscope to guide tube placement through a small abdominal incision. The tube is secured internally and externally. The procedure is quick, and recovery is often rapid.

Post-Procedure and Long-Term Care The insertion site requires daily cleaning as it heals. A dietitian provides a personalized feeding schedule. The tube must be flushed to prevent clogging. PEG tubes can last for years but may need replacement.

Conclusion

A PEG feed is a vital intervention for individuals unable to meet nutritional needs orally due to various medical conditions. It provides a safe and effective route for long-term support, maintaining health and improving quality of life. The decision for a PEG is made collaboratively, considering the patient's condition and preferences.

For more information on PEG tubes, refer to the National Institutes of Health (NIH).

Frequently Asked Questions

The main purpose of a PEG feed is to provide nutrition, fluids, and medication directly into the stomach for individuals who cannot eat or swallow safely, or who cannot ingest enough orally to meet their nutritional needs.

PEG tubes are designed for long-term use, lasting for months or years. They can be removed if the underlying medical condition resolves and the patient regains the ability to eat orally.

The procedure is minimally invasive and performed under sedation with local anesthetic, so patients do not experience pain during insertion. Some mild discomfort or soreness may occur around the insertion site for a short time afterwards.

A PEG tube is a longer-term solution inserted directly into the stomach through the abdominal wall, while an NG tube is a temporary solution inserted through the nose. PEGs are generally more comfortable and stable for extended use.

Depending on the reason for the PEG, some individuals may still be able to eat and drink small amounts by mouth, while others must follow strict restrictions determined by a healthcare provider.

Common risks include infection around the insertion site, tube blockage, or accidental dislodgement. More serious complications are possible but are much rarer.

Feeds can be given intermittently in boluses using a syringe or continuously over several hours using an electronic pump. A dietitian creates a personalized feeding plan based on the patient's nutritional needs.

Research suggests that PEG feeding does not increase life expectancy, improve quality of life, or reduce aspiration risk for patients with advanced dementia. Therefore, many guidelines recommend against it in this specific patient group.