Abdul JabbarMD Craig J McClainMD and Stephen McClaveMD

Since its initial introduction by Ponsky and colleagues in 1980, percutaneous endoscopic gastrostomy (PEG) has gained wide acceptance as a safe and efficient method of providing enteral alimentation in patients who have functionally intact gastrointestinal (GI) tracts but are unable to swallow or maintain sufficient volitional intake due to a variety of medical conditions. This procedure has been adopted by most centers and is performed in both adults and children with excellent results. Some modifications in technique have been developed, and PEG has replaced surgical gastrostomy in most settings. PEG tube placement is technically easier, less expensive, and performed more rapidly with only local anesthetics and intravenous (IV) conscious sedation, whereas surgical gastrostomy frequently requires general anesthesia. PEG placement numbers are steadily increasing; statistics indicate that PEG placements doubled over the 8 years from 1988 to 1995. In general, PEG tube placement should be considered for patients who require long term enteral feeding for > 4 weeks. For short term nutritional requirements, nasogastric (NG) tubes or nasoenteric tubes are preferred. We will review the indications, complications, nutritional benefits, and ethical issues related to PEG placement.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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