G-tube vs PEG tube- is there a difference?

[jmperry]

I work in homecare so we see lots of tubes and use g-tube & PEG interchangably and is this a good practice to do so? After one of our nurses cut a PEG tube in an effort to change it, it was learned that this tube is NEVER changed in the home setting but there was a g-tube replacement in the home. Then we looked in our policies only to see that we had not updated them to include these!!! Looking for clarification so that policies can be updated and better defined. Thanks.

[Daisy_08, BSN, RN]

PEG s are a sub type of G tubes. It has to do with the way they are inserted. You will also notice that the tubes look different-where I work pegs are white (may not be the case everywhere).You can read it in your med surg book or just google

[classicdame, MSN, EdD]

lots of differences. Some of what nurses call PEG tubes actually do not end in the stomach, but end in the duobdenum or even the jejunum. This affects what you can push through the tube, what meds can be delivered (digoxin has to be absorbed in the stomach), what feeding formulas are appropriate and how often the tube needs changing. I am putting together an inservice on this now for our hospital nurses and am learning things I never even suspected before!

[mercurysmom]

The Oley Foundation is a great resource for information related to home enteral and parenteral nutrition. They have an extensive Clinician Resource section with info guides that can be downloaded and printed, or you can order pamphlets in larger numbers as needed.

I seem to find neat stuff every time I visit their site...I was looking for something that explained the differences between PEG and PEJ tubes, vs. skin-level access tubes and traditional tubes, and I think I stumbled upon the holy grail of GI teaching:

Education Materials for Home Nutrition Support Consumers by Lisa Crosby Metzger

Quote

Parenteral and enteral nutrition (PEN) are life-sustaining therapies that can be administered in the home. They are also complex therapies, with many facets about which patients and caregivers must learn. Once home on PEN, the patient assumes much of the responsibility for day-to-day care. Although patients are trained in many aspects of home PEN management before they leave the hospital and often again upon arrival home, there is much to retain and put into practice. Many health care facilities, companies, and nonprofit organizations create home PEN patient education materials. In 1993 and 1995, directories were created to list the home nutrition support materials that were available. The 1995 directory has been updated and appended to this article. This directory was created in the spirit of the original: to encourage communication and the exchange of information between individuals and institutions. (Nutr Clin Pract. 2010;25:451-470)

This is an area of personal and professional interest, as I have recently completed a series of online CE workshops for clinicians caring for young children with Mitochondrial Cytopathies, including a section about developmental adaptations for infants and toddlers with home enteral/parenteral feeds. (The nonprofit org has not yet released the series.) In addition, I have a G tube for venting, a J tube for meds and trophic feeds, and have received home PN for the past 7 years. The only general statement I can make about enteral tubes is that it's nearly impossible to look at an external tube and know where it's going. Good luck!