indications for percutaneous endoscopic gastrostomy (PEG)

Last reviewed 05/2021

• indications for PEG feeding:
  • PEG feeding should be considered for any patient who is unable to meet his/her nutritional requirements via the oral route and who is likely to require artificial nutritional support for at least four weeks. Clinical situations in which these conditions may apply can be divided into the following broad categories:
    • A. Mechanical dysphagia due to obstruction to the upper aero-digestive tract (e.g. head and neck cancer)
    • B. Neurological dysphagia, where there is the prospect of recovery from the underlying disease (e.g. many acute strokes)
    • C. Inability to eat due to global neurological damage, where there is the prospect of recovery from the underlying disease (e.g. brain injury, reversible coma)
    • D. Where there is no problem with eating but nutritional requirements are increased due to malabsorption (e.g. cystic fibrosis, Crohn's disease)
    • E. Where there is no malabsorption or dysphagia but chronic disease is causing weight loss due to loss of appetite and/or increased catabolism (e.g chronic renal failure)
    • F. Neurological dysphagia, where the cause is a progressive neurological disorder without prospect of recovery (e.g. Motor Neurone Disease)
    • G. Inability to eat due to severe global neurological damage, where there is no prospect of recovery from the underlying disease (e.g. minimally responsive state, severe stroke)
    • H. Inability to eat due to severe dementia
    • I. Where there is refusal to eat because of a psychiatric disorder (e.g. depression or anorexia nervosa)