Is it normal to have discomfort and bleeding with PEG tube insertion?
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Peg tube placed in my 96 year old mother apx. 3 years ago. Is having discharge, discomfort and bleeding. At site area there seems to be an area that has not healed properly. Appears to be some type of pocket that fills up and becomes painful. After a bleed the pocket subsides in size and pain (described more like pressure pain) is relieved. Have had her to gastro surgeon who placed the tube and said this is normal. I have my doubts about this mainly because my husband had a PEG for seven years and there was little or no discharge after the first couple of days after surgery. I am to the point I would like a second opinion. Am I being silly or justified about my concerns.
Posted Wed, 5 Feb 2014 in General Health
Answered by Dr. Shoaib Khan 1 hour later
Brief Answer: Is seen in 10-15 % of the patients sir/ma'am Detailed Answer: Hello sir/ma'am and welcome. Thank you for writing to us. I have gone through your query with diligence and understand how this can be a cause for concern. But in my opinion and from my experience, almost 80 % of patients who have a PEG tube inserted, do not experience the discharge or trouble with healing for more than a few days after the procedure. A few individuals do experience difficulties with healing for a longer period of time, but this is mainly due to other medical conditions like insufficient blood supply to the region (proper blood supply promotes healing), conditions like diabetes, etc; that all effect the process of healing; thus resulting in such a presentation. I would also like to mention one such elderly gentleman who did not have such medical conditions that would prevent healing, but still experienced these troubling symptoms; for which we simply had to remove the tube for a few days, after which a new one was reinserted successfully. So in conclusion, I would like to say that this may be common, but it is better to rule out all such conditions that can cause such a presentation, and once these conditions have been ruled out we could either help your mother to be more comfortable with this tube, or request for a new tube to be inserted. I hope you find my response both helpful and informative. Please feel free to write back to me for any further clarifications, I would be more than happy to help. Best wishes.
Follow-up: Is it normal to have discomfort and bleeding with PEG tube insertion? 48 minutes later
You indicated removal of tube for a couple of days to alleviate the problem and reinserting the tube. Would reinsertion of the tube be done as the first procedure (surgically) or would a retainer be placed in the affected opening until healing takes place, the new PEG inserted into the same opening? Don't want to put her through a surgical procedure at her age unless absolutely necessary. Guess what I am asking is, won't the hole close after an extended removal period? In my PEG kit I was given a retainer to use, should the PEG come out, until I was able to get my husband into the facility for reinsertion. The advice being, "use the retainer to keep the hole from closing". What kind of time period are we talking about...I only had about an hours drive to the facility...is the PEG being out for a couple of days a problem that will require a surgical procedure?
Answered by Dr. Shoaib Khan 14 minutes later
Brief Answer: All queries addressed sir/ma'am Detailed Answer: Hello once again. A retainer would be inserted in the current location until healing takes place. Her doctor will decide if a new tube may be inserted simultaneously in a new location or whether they wish to use the same location after healing takes place to improve the currently used site. I understand how her age is a factor here, which is why I would also keep removal and reinsertion as the last option. Yes sir/ma'am, the hole would close after prolonged duration after removal. But as mentioned earlier, her doctor will have to decide whether or not your mother can tolerate the procedure, and whether a new tube can be reinserted in a new site or the old one should be used. Yes sir/ma'am, removal of the PEG tube for a short period of time can initiate the healing process that would result in closing of the hole. Well time period can vary from one individual to another, and as I mentioned in my previous response a few medical conditions can also influence this duration, but in a normal individual the time taken for complete closure of this hole can vary from about 3-7 days. I hope I have addressed your current issues. Please feel free to write back to me for any further clarifications, I am always available to help. God bless.