Percutaneous Endoscopic Gastrostomy (PEG) Placement or Replacement with Endoscopy: Getting Ready for Your Procedure
What is a PEG tube?
A PEG tube is a type of feeding tube. It is put through the abdominal wall into the stomach during an upper endoscopy (EGD). A small incision (cut) is made on the left side of the abdomen. Then, a small, flexible, tube (catheter) with a balloon or flared tip is put through the stomach.
This is also called gastrostomy tube insertion, g-tube insertion, and stomach tube insertion.
You will be given medicines (sedatives) in an IV to help you relax. These will make you sleepy and you may not remember the exam. You cannot drive for 24 hours after sedation. After the exam, you may feel pressure, cramping, or gas pain. People who have a uterus and ovaries and are 10 to 55 years of age, or are having periods, may be asked for a urine sample.
After the procedure, you may need to stay the night in the hospital.
Getting ready for your procedure
| When: |
What to do: |
| 2 weeks (14 days) before your procedure |
☐ Read and follow the recommendations in the Medicines section. If you take a GLP-1 medicine (see the list below), you will have a different diet prep that starts at 8:00 a.m. the day before your procedure.
|
| 3 days before your procedure |
☐ Stop taking SGLT-2 inhibitor medicines.
|
| 1 day before your procedure |
☐ 11:00 p.m.: Start a clear liquid diet. See the Clear Liquid Diet table.
☐ Do not drink alcohol.
|
| Day of your procedure |
☐ Make sure you have a driver. You cannot drive for 24 hours, take a taxi or bus, or leave alone. A responsible person must check in and stay in the building while you are here.
☐ If you have a CPAP or BPAP, bring the machine and mask with you.
☐ Do not take chalky antacids, fast-acting insulin, or diabetes medicines. See the Medicines section.
☐ Do not drink alcohol.
☐ Starting 2 hours before check-in: Do not eat or drink anything. If you eat or drink anything, your procedure will be delayed or canceled.
|
Medicines (what to take and not take)
| Medicine |
Examples |
When to stop taking |
Other instructions |
| Phentermine |
|
14 days before your procedure
|
| Blood thinners |
-
Brilinta (ticagrelor)
-
Coumadin (warfarin)
-
Effient (prasugrel)
-
Eliquis (apixaban)
-
Lovenox (enoxaparin)
-
Plavix (clopidogrel)
-
Pradaxa (dabigatran)
-
Xarelto (rivaroxaban)
|
Call the doctor that prescribed your blood thinners. Ask them when to stop taking it.
|
| SGLT-2 inhibitors |
|
3 days before your procedure
|
| Chalky antacids and iron pills |
|
The day of your procedure
|
| Fast-acting insulin or diabetes medicine |
-
Glucophage, Fortamet (metformin)
-
Humalog, Apidra, NovoLog (insulin)
|
The day of your procedure |
-
Take long-acting insulin as ordered.
-
If you have an insulin pump, call the doctor that monitors it for instructions on changing the dose.
|
| GLP-1 agonists |
-
Byetta (exenatide)
-
Mounjaro, Zepbound (tirzepatide)
-
Ozempic, Wegovy (semaglutide)
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Saxenda, Victoza (liraglutide)
-
Trulicity (dulaglutide)
|
Keep taking your medicine.
You will have a different diet prep if you take a GLP-1. Follow the instructions to the right.
|
-
8:00 a.m. the day before your procedure: Start a full liquid diet. Drink this until 11:00 p.m.
-
11:00 p.m. the night before your procedure: Start a clear liquid diet. Drink this until 2 hours before your procedure arrival time.
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2 hours before your procedure check in time: Stop drinking clear liquids.
|
Clear liquid diet
| Okay to drink (clear liquids) |
Do not drink (non-clear liquids) |
|
Do not drink any clear liquids that are red, blue, or purple.
-
Clear liquids cannot be hazy or cloudy. They cannot have pulp or fats.
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Only apple or white grape juice.
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Black coffee (no milk, cream or nondairy creamer)
-
Clear tea without milk or cream
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Infant electrolyte drinks like Pedialyte
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Clear sports drinks like Gatorade
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Clear carbonated drinks like Sprite or 7-Up
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Clear, fat-free broth like Swanson Fat-Free Chicken Broth, Kroger 99% Fat Free Chicken Broth, Kroger Fat Free Beef Stock, College Inn 99% Fat Free Chicken Broth
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Clear protein drinks like Ensure Clear, Premier Protein Clear, Fizzique
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Water
-
Do not add milk, creamer, honey, or lemon to any clear liquid drinks.
|
-
Milk
-
Coconut water
-
Jello
-
Hot chocolate
-
Coffee or tea with milk, cream, honey, or nondairy creamer
-
Orange juice (with or without pulp) and other fruit juices
-
Smoothies
-
Tube feeding formulas like Promote, Impact, and Nepro
|
|
Do not drink alcohol.
|
Full liquid diet (for patients taking GLP-1 medicines)
If you take a GLP-1 medicine, go to the Medicines section for instructions on when to start a full liquid diet.
| Full liquids |
-
Boost, Ensure, Resource, and other liquid supplements
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Butter, margarine, oil, cream, custard, and pudding
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Fruit ices and popsicles
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Fruit juices, including those with nectars and pulps
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Gelatin (Jello)
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Plain ice cream, frozen yogurt, and sherbet
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Soup broth (bouillon, consomme, and strained cream soups, but no solids)
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Sodas, such as ginger ale and Sprite
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Sugar, honey, and syrups
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Tea or coffee with cream or milk and sugar or honey
-
Water
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