Gastrostomy, percutaneous endoscopic (PEG)

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Gastrostomy, percutaneous endoscopic (PEG)

Gastrostomy, percutaneous endoscopic (PEG)

A surgical procedure for placing a feeding tube without having to perform an open laparotomy (operation on the abdomen). The aim of PEG is to feed those who cannot swallow. PEG may be done by a surgeon, otolaryngologist (ENT specialist) or gastroenterologist (GI specialist). It is done in a. hospital or outpatient surgical facility. Local anesthesia (usually lidocaine or another spray) is used to anesthetize the throat. An endoscope (a flexible, lighted instrument) is passed through the mouth, throat and esophagus to the stomach. The surgeon then makes a small incision (cut) in the skin of the abdomen and pushes an intravenous cannula (an IV tube) through the skin into the stomach and sutures (ties) it in place. The patient can usually go home the same day or the next morning. Possible complications include wound infection (as in any kind of surgery) and dislodging or malfunction of the tube. Percutaneous endoscopic gastrostomy may be a mouthful (as a term) but it describes the procedure accurately. A gastrostomy (a surgical opening into the stomach) is made percutaneously (through the skin) using an endoscope to put the feeding tube in place. PEG takes less time, carries less risk and costs less than a classic surgical gastrostomy which requires opening the abdomen.

RELATED TERMS
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Laparotomy
Surgical incision through the flank or loin or, less precisely, the abdominal wall, as for the purpose of exploring the morphology of the internal reproductive organs.

Otolaryngologist
A physician who specializes in the treatment of the ears, nose, and throat.

Gastroenterologist
A physician who specializes in digestive diseases.

Local
In the area of the tumor; confined to one specific area.

Anesthesia
Depending on the type of treatment a patient is to receive, a dentist may recommend some type of dental anesthesia. Local anesthesia involves the numbing of the teeth and gums. Topical anesthetic may be used to help make the injection more tolerable. Most dental work falls under this type of anesthesia (i.e., fillings, crowns, root canals and gum surgery) and may cause the patient to feel a temporary numbness. Nitrous Oxide or "laughing gas" may be used in combination with local anesthetics or alone if the patient cannot tolerate a local injection. Nitrous Oxide is an anti-anxiety agent that helps relax both children and adults. Patients wear a mask to breathe in the nitrous air. The effects soon dissipate once the nitrous is turned off and the patient begins to breathe oxygen through the mask. There are very few known side effects with Nitrous Oxide. General anesthesia is used during more complex procedures or for those that experience a high level of anxiety and wish to be asleep during the treatment. An anesthesiologist or a dentist who has received special training administers general anesthesia. Sometimes oral medications are used to relieve dental pain or anxiety. These analgesics may be used in combination with the above types of anesthesia or alone to help relieve post treatment discomfort.

Lidocaine
Lidocaine is a prescription or over-the-counter drug which is (or once was) approved in the United States and possibly in other countries. Active ingredient(s): lidocaine.

Endoscope
A small, flexible tube with a light and a lens on the end. It is used to look into the esophagus, stomach, duodenum, colon, or rectum. It can also be used to take tissue from the body for testing or to take color photographs of the inside of the body. Colonoscopes and sigmoidoscopes are types of endoscopes.

Esophagus
The organ that connects the mouth to the stomach. Also called gullet.

Stomach
The organ between the esophagus and the small intestine. The stomach is where digestion of protein begins.

Incision
A cut made with a sharp instrument through the skin or other tissue.

Skin
Skin is an organ of the integumentary system; which is composed of a layer of tissues that protect underlying muscles and organs. Skin is used for insulation, vitamin D production, sensation, and excretion (through sweat).

Abdomen
The area between the chest and the hips. Contains the stomach, small intestine, large intestine, liver, gallbladder, pancreas, and spleen.

Intravenous
Introducing a fluid into the bloodstream through a vein (usually in the patient's forearm).

Cannula
Simply a slender tube that can be inserted into a body cavity or duct. During the insertion of the cannula, its lumen (interior) is usually occupied by a trocar, a solid shaft, to stiffen it.

Wound
A wound is a physical trauma where the skin is torn, cut or punctured. Exposed to air, there is not only a significant chance of death due to loss of blood, but increased chance of bacteria entering the wound or an infection.

Infection
Anything that invades the body and reproduces. Infections can be bacteria, protozoa, fungi, or viruses. Bacteria and fungi are one celled creatures that cause many infections including strep throat, bladder infections, and some lung infections. Fungi cause “athlete’s foot” and thrush, an infection in the mouth. Protozoa are small organisms with many cells that can cause infections in the guts or in the lungs. Most healthy people do not get protozoal infections, but people with suppressed immune systems can. Viruses are not really organisms; they are tiny particles that can live only inside another cell. They reproduce by taking over a cell and causing that cell to make more virus particles, rather than doing what the cell is supposed to do. Viruses cause most colds and flu cases.

Percutaneous
Passing through the skin.

Gastrostomy
An artificial opening from the stomach to a hole (stoma) in the abdomen where a feeding tube is inserted. See also enteral nutrition.

Risk
In clinical trials, the probability of harm or discomfort for subjects, arising from the test product. Acceptable risk differs depending on the condition for which a product is being tested. A product for sore throat, for example, will be expected to have a low incidence of side effects. However, unpleasant side effects may be an acceptable risk when testing a promising treatment for a life-threatening illness.

SIMILAR TERMS
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Gaston Memorial Hospital
The Gaston Memorial Hospital is a hospital in Gastonia, North Carolina, United States.

Gastrectomy
An operation to remove all or part of the stomach.

Gastric
Related to the stomach.

Gastric atrophy
A condition in which the stomach muscles shrink and become weak. It results in a lack of digestive juices. Gastritis: Inflammation of the stomach.

Gastric banding
A surgically implanted device used to help a person lose weight. In a surgical procedure, a band is placed around the upper part of the stomach, creating a small pouch that can hold only a small amount of food. The narrowed opening between the stomach pouch and the rest of the stomach controls how quickly food passes from the pouch to the lower part of the stomach. The system helps the patient eat less by limiting the amount of food that can be eaten at one time and increasing the time it takes for food to be digested.

Gastric cancer
Cancer of the stomach, the major organ that holds food for digestion. Worldwide, stomach cancer is the second most frequent cancer and the second leading cause of death from cancer. It can develop in any part of the stomach and spread to other organs.

Gastric emptying study
A gastric emptying study evaluates the emptying of food from the stomach. For a gastric emptying study, a patient eats a meal in which the solid food, liquid food or both are mixed with a small amount of radioactive material. A scanner (acting like a Geiger counter) is placed over the stomach to monitor the amount of radioactivity in the stomach for several hours after the test meal. In patients with abnormal emptying of the stomach, the food and radioactive material stay in the stomach longer than normal (usually hours) before emptying into the small intestine.

Gastric juices
Liquids produced in the stomach to help break down food and kill bacteria.

Gastric MALT lymphoma
A low-grade malignant lymphoma of the stomach associated with chronic infection by the bacterium H. pylori. Three-quarters of gastric MALT lymphomas regress after the eradication of H. pylori with antibiotics. The one-quarter that are unresponsive to antibiotics carry a characteristic chromosomal translocation or are at an advanced stage. The translocation is of the t(11;18)(q21;q21) type.

Gastric outlet
The exit from the stomach through the pyloric channel and duodenum.

Gastric outlet obstruction
Any disease that mechanically impedes gastric emptying, the normal emptying of the stomach. There is obstruction of the channel of the pylorus and duodenum through which the stomach empties. The cause of the obstruction may be a benign or malignant disease. The most common malignancy that produces gastric outflow obstruction is pancreatic cancer. The benign causes of gastric outflow obstruction include pyloric ulcer and gastric polyps in adults, pyloric stenosis and congenital duodenal webs in children, and the ingestion of caustic substances in all age ranges. Gastric outlet obstruction may be abbreviated GOO.

Gastric resection
An operation to remove part or all of the stomach.

Gastric stapling
A surgical procedure that converts the upper part of the stomach into a very small pouch by stapling portions of the stomach together, forcing an obese person to eat only tiny portions yet still feel full. It is normally done only in severe cases, and in combination with diet and exercise. A similar operation is called gastric banding.

Gastric ulcer
See stomach ulcer.

Gastrin
A hormone released after eating, which causes the stomach to produce more acid.

Gastritis
An inflammation of the stomach lining.

Gastrocolic reflex
Increase of muscle movement in the gastrointestinal tract when food enters an empty stomach which may cause the urge to have a bowel movement right after eating.

Gastrocrom
Gastrocrom is a prescription or over-the-counter drug which is (or once was) approved in the United States and possibly in other countries. Active ingredient(s): cromolyn sodium.

Gastroenteritis
An infection or irritation of the stomach and intestines, which may be caused by bacteria or parasites from spoiled food or unclean water. Other causes include eating food that irritates the stomach lining and emotional upsets such as anger, fear, or stress. Symptoms include diarrhea, nausea, vomiting, and abdominal cramping. See also infectious diarrhea and travelers' diarrhea.

Gastroenterologist
A physician who specializes in digestive diseases.

Gastroenterology
The field of medicine concerned with the function and disorders of the digestive system.

Gastroesophageal
Pertaining to both the stomach and the esophagus, as in the gastroesophageal junction, the place where the esophagus connects to the stomach.

Gastroesophageal junction
The junction between the stomach and the esophagus; the place where the esophagus connects to the stomach.

Gastroesophageal reflux
The return of stomach contents back up into the esophagus This frequently causes heartburn because of irritation of the esophagus by stomach acid.

Gastroesophageal reflux disease (GERD)
Flow of the stomach's contents back up into the esophagus, which happens when the muscle between the esophagus and the stomach (the lower esophageal sphincter) is weak or relaxes when it shouldn't. May cause esophagitis. Also called esophageal reflux or reflux esophagitis.

Gastrografin
Gastrografin is a prescription or over-the-counter drug which is (or once was) approved in the United States and possibly in other countries. Active ingredient(s): diatrizoate meglumine; diatrizoate sodium.

Gastrointestinal
Having to do with the stomach and intestines.

Gastrointestinal stromal tumor
GIST. A type of tumor that usually begins in cells in the wall of the gastrointestinal tract. It can be benign or malignant. Malignant GISTs can occur from the esophagus to the rectum, but occur most commonly in the stomach and small intestine. Treatment for GIST includes STI571 (Gleevec), the first approved drug to directly turn off the signal of a protein known to cause a cancer.

Gastrointestinal tract
The tube that extends from the mouth to the anus in which the movement of muscles and release of hormones and enzymes digest food. The gastrointestinal tract starts with the mouth and proceeds to the esophagus, stomach, duodenum, small intestine, large intestine (colon), rectum and, finally, the anus. Also called the alimentary canal, digestive tract and, perhaps most often in conversation, the GI tract.

Gastrointestinal tract (GIT)
The large, muscular tube that extends from the mouth to the anus, where the movement of muscles and release of hormones and enzymes digest food. Also called the alimentary canal or digestive tract.

Gastromark
Gastromark is a prescription or over-the-counter drug which is (or once was) approved in the United States and possibly in other countries. Active ingredient(s): ferumoxsil.

Gastroparesis
Nerve or muscle damage in the stomach. Causes slow digestion and emptying, vomiting, nausea, or bloating. Also called delayed gastric emptying.

Gastropathy
Disease of the stomach, as in hypoproteinemic hypertrophic gastropathy.

Gastroschisis
A birth defect in which there is a separation in the abdominal wall. Through this opening protrudes part of the intestines which are not covered by peritoneum (the membrane that normally lines the inside of the abdomen). The opening in the abdominal wall in gastroschisis is never at the site of the umbilicus (the navel or belly button). Rather, the umbilicus is characteristically to the left of the gastroschisis and is separated from it by a bridge of skin.

Gastroscope
A flexible, lighted instrument that is put through the mouth and down the esophagus to view the stomach. Tissue from the stomach can also be removed through the gastroscope.

Gastrostomy
An artificial opening from the stomach to a hole (stoma) in the abdomen where a feeding tube is inserted. See also enteral nutrition.

Gastrovist
Gastrovist is a prescription or over-the-counter drug which is (or once was) approved in the United States and possibly in other countries. Active ingredient(s): diatrizoate meglumine; diatrizoate sodium.

PREVIOUS AND NEXT TERMS
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Gastrointestinal stromal tumor
GIST. A type of tumor that usually begins in cells in the wall of the gastrointestinal tract. It can be benign or malignant. Malignant GISTs can occur from the esophagus to the rectum, but occur most commonly in the stomach and small intestine. Treatment for GIST includes STI571 (Gleevec), the first approved drug to directly turn off the signal of a protein known to cause a cancer.

Gastrointestinal tract
The tube that extends from the mouth to the anus in which the movement of muscles and release of hormones and enzymes digest food. The gastrointestinal tract starts with the mouth and proceeds to the esophagus, stomach, duodenum, small intestine, large intestine (colon), rectum and, finally, the anus. Also called the alimentary canal, digestive tract and, perhaps most often in conversation, the GI tract.

Gastropathy
Disease of the stomach, as in hypoproteinemic hypertrophic gastropathy.

Gastroschisis
A birth defect in which there is a separation in the abdominal wall. Through this opening protrudes part of the intestines which are not covered by peritoneum (the membrane that normally lines the inside of the abdomen). The opening in the abdominal wall in gastroschisis is never at the site of the umbilicus (the navel or belly button). Rather, the umbilicus is characteristically to the left of the gastroschisis and is separated from it by a bridge of skin.

Gastroscope
A flexible, lighted instrument that is put through the mouth and down the esophagus to view the stomach. Tissue from the stomach can also be removed through the gastroscope.

Gastrostomy, percutaneous endoscopic (PEG)

Gaucher disease
A series of 5 diseases due to deficient activity of the enzyme glucocerebrosidase, leading to accumulation of glucocerebroside in tissues of the body. The 5 types of Gaucher disease encompass a continuum of clinical findings from a lethal form before or just after birth to a form so mild that it may not be diagnosed until old age. All 5 types of Gaucher disease are inherited in an autosomal recessive manner.

Gaucher disease, type 1
The most common and best known form of Gaucher disease. It affects the spleen, liver, and bone marrow and spares the brain. The symptoms include enlargement of the spleen (usually the first sign), anemia, low blood platelets, increased skin pigmentation, and a yellow fatty spot on the white of the eye (a pinguecula). Severe bone involvement can lead to pain and collapse of the bone of the hips, shoulders, and spine.

Gaucher disease, types 2-5
A series of disease due to glucocerebrosidase deficiency and accumulation of glucocerebroside in cells. By comparison with type 1 Gaucher disease, these are far less frequent forms of Gaucher disease.

Gay gene
A gene located on the X chromosome which was alleged to determine male homosexuality. The "gay gene" was dubbed homosexuality 1 (HMS1) and the male sexual orientation gene. It was thought to be in chromosome band Xq28. However, one would expect there to be strong selective pressures against a gene for male homosexual orientation. The original claim for the "gay gene" was made in 1993 by Dean H. Hamer and colleagues. There has been no independent confirmation of the existence of a "gay gene" and today there is considerable doubt about its existence.

Gay suicide risk
High rates of suicide have consistently been reported among homosexuals, particularly among adolescents and young adults.

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