“What actually is a feeding tube?” The question sounds banal at this point. Nevertheless, I think it makes sense to clarify the terminology first. Because when you’re confronted with this topic for the first time, it’s important to know what we’re actually talking about. If you’re unlucky, you (like me at the time) come into contact with the subject through a doctor who doesn’t communicate it well. Either because they assume knowledge that may not even exist yet. Or because they explain the whole thing far too superficially. The reason for this does not always have to be a lack of empathy; unfortunately, many doctors are simply overworked these days.
General information about the feeding tube
Generally speaking, a feeding tube is a medical device. It allows the nasopharynx, oesophagus and stomach entrance to be bypassed when eating. It is therefore no longer necessary to ingest, chew and swallow food through the mouth. The reasons why this may be necessary vary greatly. As a rule, there is a medical reason (at least I have never met anyone who simply has a feeding tube just like that), i.e. an acute or chronic illness. From muscle weakness, a stroke, dementia, extreme anorexia, a cognitive disability, a tumour or even paralysis caused by an accident, there can be many reasons why someone needs a feeding tube. The great thing is, however, that no matter why someone can no longer eat properly, help is available today. Nobody has to starve to death for medical reasons.
Nasal feeding tube
There are different types of gastric tubes, depending on the reason for use and the expected duration of the treatment. All of them are a thin, flexible tube made of durable, rubber-like plastic that is inserted into the stomach via various routes. This can then be filled with liquid food via the gastric tube.
If the feeding tube only needs to be used for the foreseeable future (usually less than four weeks), this tube is pushed down the oesophagus into the stomach via the nose and the back of the throat. This can be done under anaesthetic or (the usual procedure) while the patient is awake.
PEG feeding tube
The PEG is a solution that is designed for the long term. The acronym PEG stands for percutaneous endoscopic gastrostomy. This refers to the way in which a PEG is placed (you can find out more about this in this article). Even though PEG does not actually refer to the tube but to the technique used to place it, in everyday life it is often referred to simply as a PEG rather than a PEG tube. Although it is assumed with a PEG that the person will have to be fed via a feeding tube permanently or at least for a longer period of time, this procedure can also be reversed. This article describes exactly how a PEG tube is constructed.
As I myself have been living with a PEG gastric tube for over 20 years, this blog is almost exclusively about this type of gastric tube.
Button
A so-called button is essentially a variant of the PEG. Instead of a plastic plate, the button is held in the stomach with the help of a small balloon filled with fluid. The special thing about this is that this balloon can be filled and deflated through the tube’s insertion channel. This makes it possible to replace a button without the need for a new operation, just through the insertion channel. In contrast to a PEG, a button does not have a longer tube outside the abdomen, but only a connector with a cap.
There will be a direct comparison between PEGs and buttons in a later (guest) article.
Gastrotube
A Gastrotube combines the advantages of a button and a PEG. As the name suggests, the Gastrotube also has a piece of tubing outside the body. Just like a PEG. In contrast, a Gastrotube is not held in the stomach with a retaining plate but, like a button, with the help of a balloon. This means that a Gastrotube can also be changed independently. Due to its design and the need to have a line into the stomach and for filling and draining the balloon along with the corresponding connections, a Gastrotube is less compact and therefore less practical than a PEG tube.
PEJ feeding tube
As with PEG, the acronym for PEJ actually stands for the procedure used to create the device. It refers to percutaneous endoscopic jejunostomy. In contrast to the PEG, the PEJ does not access the stomach but the small intestine. As this also bypasses the digestion of food in the stomach, only specially suitable tube feeds may be administered via a PEJ.
