Gastrostomy

A gastrostomy is a small opening made through the skin into your stomach, where a feeding tube is inserted. This tube allows you to put nutrition, fluids, and medicines directly into your stomach should eating or drinking by mouth become difficult.

If it’s still safe to swallow, you can keep eating and drinking by mouth. The feeding provides extra support, making it easier to meet your nutrition needs when you cannot eat or drink enough.

Some muscle wasting conditions affect the muscles you use to chew and swallow. This can make eating and drinking slow or tiring. Over time, it may become unsafe. For example, if food or drink goes down the wrong way into the lungs, it can cause choking or chest infections.

Your condition may mean you feel full quickly, find it hard to eat enough, or be too tired to shop and prepare meals. This can lead to weight loss, low energy, or missing important nutrients.

If you or your child are losing weight or not eating enough, your healthcare team will refer you to a dietitian. A dietitian can help you change your diet and may suggest supplements. If these aren’t enough, they may recommend a gastrostomy.

If you have trouble chewing or swallowing, you may also be referred to a Speech and Language Therapist. They can assess your needs, suggest changes to your diet, and work with your dietitian to discuss whether a gastrostomy might help.

A gastrostomy might help if:

• Swallowing has become slow, tiring, or unsafe
• You’re at risk of food or drink going down the wrong way (aspiration), which can cause chest infections
• You’re finding it hard to eat enough, even with extra support
• Mealtimes have become stressful, exhausting, or upsetting

Sometimes, your team may suggest placing the tube early to avoid complications later. This is based on your individual needs.

Having a gastrostomy does not mean you have to stop eating if swallowing is still safe. Many people continue to enjoy food and drink alongside tube feeding.
It’s normal to feel unsure about having a feeding tube. It can feel like a big step – but many people find it makes life easier. It can help ease the pressure of eating, boosts energy, and become a manageable part of life. Talk to your healthcare team about any concerns.

A gastrostomy is usually carried out in hospital as a planned procedure. The most common method is PEG (percutaneous endoscopic gastrostomy).

Before the procedure, you should have a respiratory assessment. If you use ventilation, you may be referred to a chronic respiratory failure team for specialist care.

You’ll be given medicine to keep you comfortable.

• Adults are usually given sedation to relax and a local anaesthetic to numb the area
• Children usually have a general anaesthetic, so they’re asleep

People living with a muscle wasting condition, or with a family history of one, may need extra checks or precautions when having an anaesthetic. We have information on anaesthetics and muscle wasting conditions.

During the procedure, a thin tube with a camera (endoscope) is gently passed through the mouth into the stomach. This helps the doctor see where to place the feeding tube. A small opening is made through the skin, and the feeding tube is inserted into the stomach.

The tube is held in place with a small disc or balloon inside the stomach and a piece outside on your skin. The procedure usually takes under an hour.

If a PEG is not suitable, another method like RIG (radiologically inserted gastrostomy) may be used. RIG tubes are held in place with a balloon. Your doctor will explain what’s safest and discuss any risks beforehand.

After the procedure

You or your child will go to a recovery area while the sedation or anaesthetic wears off.

It’s normal to feel sore in the area where the tube was placed – this should ease in a few days. You’ll be offered pain relief if required. You may need to stay in hospital overnight.

Your healthcare team will:

• Check the tube is in the right place
• Clean the area and show you (and carers, if needed) how to care for it
• Start small amounts of fluid or feed through the tube
• Refer you or your child to the local community home enteral dietetic team and feed company nurses

You’ll be given contact details for support when you are home. A community nurse or dietitian may visit you, and you’ll have follow-up appointments to check how things are going.

It’s completely normal to feel unsure at first – but with time, support, and practice, your confidence will grow.

You’ll be given:

• The liquid feed tailored to meet your or your child’s nutritional needs
• Any equipment needed, like syringes, giving sets, and tube care supplies

Your dietitian will work with you to choose the right type and amount of feed and explain how to use it. The aim is to fit feeding into your usual routine as much as possible. This may mean giving small amounts of liquid feed at different times during the day or using a small pump machine to deliver feed safely overnight.

Once you are home, a specialist homecare company usually delivers your feed and equipment. They’ll also provide contact details for delivery or supply issues.

It’s important to keep the area clean and dry, and to check it daily. You’ll be given clear instructions on how to flush the tube, keep it secure, and spot any signs of problems.

Contact your healthcare team if:

• The skin around the tube is red, swollen, sore, or bleeding
• You notice leaking around the tube
• The tube is blocked, loose, or falls out – if it falls out, it’s important to keep the opening open so a new tube can be safely inserted without the need for a procedure
• You feel unwell, have a temperature, or are worried something is not right
• You’re not able to tolerate the feed or water down the tube, resulting in vomiting or diarrhoea

Your team is there to support you and help prevent any complications.

Many people with muscle wasting conditions use a gastrostomy long-term as part of their care. If your needs change, the tube can be removed. Your healthcare team will keep checking in with you and will help plan what’s best.