Difficulties with percutaneous endoscopic gastrostomy (PEG): a practical guide for the endoscopist

Background

Percutaneous endoscopic gastrostomy (PEG) is a widely used and effective means of providing long-term nutrition in patients with inadequate oral intake. The demand for this intervention has risen steadily since the early 1990s. Endoscopists who perform PEG insertion have become increasingly concerned about inappropriate use of this intervention.

Aims

This review addresses the particular areas of difficulty, namely, dementia, stroke, aspiration pneumonia and use of PEG to facilitate discharge from hospital.

Methods

A Pubmed literature search and the author’s personal experience.

Conclusions

Strategies for improving patient selection and a practical approach to difficult decisions are described.