Common PEG Tube Problems and How to Prevent Them

Each year during the first week of February, The Feeding Tube Awareness Foundation celebrates Feeding Tube Awareness Week. The event, scheduled to take place February 7-11, 2022, was founded in 2011 in an effort to “promote the positive benefits of feeding tubes as life-saving interventions.” Organizers use the occasion to increase awareness about tube feeding and educate the public on the challenges that individuals with feeding tubes and their families face.

With Feeding Tube Awareness Week right around the corner, we're using this article to discuss some common percutaneous endoscopic gastronomy (PEG) tube problems and how to prevent them. In it, we highlight several potentially serious issues that feeding tube users face, including infection, leakage, and obstruction. By the time you’re finished reading, you’ll know how to spot the signs of trouble, ensuring your loved one thrives.

Tube feeding has come a long way since it was first invented. Modern PEG tubes are discreet, comfortable, and relatively easy to maintain. Still, complications can arise. That’s why it’s so important for family caregivers to know how to spot common PEG tube problems, including:

Feeding tube blockages. If your care recipient’s feeding tube gets blocked or clogged, they won’t be able to get the vitamins, nutrients, and medication needed to live an active, vibrant life. What’s more, blockages increase the risk of other more serious issues, like an infection.

Thankfully, it’s possible to prevent most feeding tube blockages before they occur. The key is proper maintenance. Flush your loved one’s feeding tube with at least one ounce of water before and after administering meals and snacks or medication.

Feeding tube leaks. A feeding tube leak can occur in one of two specific areas –– at the end of the feeding tube itself or around the stoma (the opening in your care recipient’s abdomen that connects the feeding tube to their stomach and digestive tract).

Almost everyone with a feeding tube experiences leaks occasionally. Often, applying a gauze dressing or a barrier cream around the stoma is enough to absorb the moisture and prevent further issues. If your loved one’s stoma continues leaking or the leakage occurs alongside abdominal pain, contact a doctor right away.

Aspiration. Aspiration occurs when food, liquid, or medication gets in your loved one’s airways as a result of tube feeding. To reduce the risk of aspiration, it’s important to eat all meals and snacks sitting upright. If that’s not possible, place a pillow behind your care recipient’s lower back to help lift them up.

Infection of the stoma. If you don’t regularly clean your care recipient’s feeding tube or their feeding tube fits loosely around their stoma, they might develop an infection. Symptoms of infection include redness, inflammation, pain, and sensitivity. As the infection gets worse, the stoma might also ooze blood or pus. If your loved one experiences any of these symptoms, contact their primary care physician.

Feeding tube dislodgement. People with low-profile gastrostomy tubes are more likely to experience tube dislodgement, a problem characterized by a feeding tube falling out. There’s no easy way to fix this issue at home. Call your loved one’s physician for help or visit the nearest emergency room.

There’s no way to prevent feeding tube problems entirely, but there are several things you can do as a caretaker to significantly reduce your loved one’s risk, including:

1) Read and follow the instructions. One of the easiest ways to reduce the risk of feeding tube problems is to carefully read and follow the instructions on your loved one’s feeding tube, formulas, and medications. When you adhere to the recommended portion sizes and administration rates, you’re much less likely to encounter issues like clogs, leaks, or aspiration.

2) Flush the tube after every feeding. It might seem tedious, but to keep a feeding tube free of clogs, it needs to be rinsed before and after every snack and meal. The same rule applies to medication.

3) Clean the stoma site daily. The area where your loved one’s feeding tube enters their body is very susceptible to infection. Therefore, it’s crucial to inspect and clean it daily. To prevent harmful bacteria from building up, gently wash the area with soap and warm water. If the stoma has any drainage, wipe it up with a clean cloth and apply a barrier cream to prevent irritation.

4) Look for signs of infection. When cleaning your care recipient’s stoma, look for signs of infection like redness, swelling, or visible irritation. If any of these symptoms are present, or the site is oozing pus or blood, visit the doctor immediately.

5) Administer meals, snacks, and medication in an upright position. If you care for someone who uses a feeding tube, administer their meals, snacks, and medicines when they’re sitting up. If they’re confined to bed, encourage them to sit at a 45-degree angle for at least an hour after eating.

Tube feeding isn’t always easy, but with a little bit of research and lots of practice, you can master the art, just like millions of other family caregivers.

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