Rahnemai-Azar A, Rahnemaiazar A, Naghshizadian R, et al. Percutaneous endoscopic gastrostomy: Indications, technique, complications and management. World J of Gastroenterol. 2014;20(24):7739-51. This is for the individual who is ambulatory and feels the long PEG tube is socially inconvenient (not to be confused with Replacement balloon PEG which also has got a balloon as a retaining device) If the gastrostomy is being formed radiologically, you will need a drink of barium the evening before the procedure. This usually comes as a milkshake or can be given down an NG tube – it travels through the digestive system to the large intestine so it can be seen clearly during the insertion procedure. You should have a bath or shower and hair wash the night before the operation. You should remove any makeup, jewellery or nail varnish.

If you experience incontinence and wear pads, you will need clothing which is discrete, which keeps pads in place and allows you to change pads easily when required. If you wear a catheter, please see the section below. Look for styles with large fittings, such as big buttons and chunky belts that are easier to manipulate. Before going to the operating theatre, you will meet the doctor who will explain the operation in detail, discuss any worries you may have and ask you or your child to give permission for the operation by signing a consent form.Choose styles which make it easy to move clothing out of the way, for example elasticated waistbands on trousers, or a wrap around skirts

Tops with a looser fit across the shoulders and upper arms will be more comfortable if you self-propel Limb supports to assist with dressing are designed to provide dressing support to a person who has had an amputation. Balloon GJ device – Inserting a balloon button GJ device can usually be done while awake. However, if a tube device is already in place, or if the tract in the skin needs to be stretched to accommodate the bigger GJ device, your doctors may suggest having a general anaesthetic to take out the old device and insert the new one. The person bringing you to the operation should have ‘Parental Responsibility’ for you. Parental Responsibility refers to the individual who has legal rights, responsibilities, duties, power and authority to make decisions for a child. If the person bringing you does not have Parental Responsibility, we may have to cancel the operation. For example, although a man may usually stand to urinate, if you are unstable, you may find that sitting is a safer, easier option. It also means that you do not need to worry about holding items of clothing whilst using the toilet.

Gkolfakis P, Arvanitakis M, Despott EJ, et al. Endoscopic management of enteral tubes in adult patients – Part 2: Peri- and postprocedural management. European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy. 2021;53(2):178-195. o After 6 hours the tube will be flushed with 50mls of sterile water. If your PEG is required for feed or medication, these can be given via the PEG the following morning but not before. You will be prescribed a special liquid feed, which contains all or most of the nutrients you need. Please talk to your dietitian if you would like to know more about it. You may be able to also continue to eat regular food by mouth, using the GJ to ‘top-up’ their nutrient levels, but this depends on the reasons why it is required. Your doctors and dietitians will talk to you about this. You will need to ‘flush’ the device before and after giving feeds or medicines. We will show you how to do this.