PEG Tube Advance and Rotate

For anyone caring for someone who is fed through a PEG tube, I would like to share this information which is based on our recent experience.

Mum has had the PEG since she first had the stroke over 3 years ago.

Our initial advice on how to look after was to clean the site and advance and rotate the tube once a week. This was given to us on discharge from the hospital as part of the “How to care for …” information pack.

At some point, possible 6 months to a year later, the HEN dietician sent us an update saying there are new guidelines on PEG site care and that they now suggest the advance and rotate is done daily.

This sounded a bit strange and excessive, but we were given a written document with this and so we started following this new advice.

In recent months the condition of the PEG site has deteriorated and whilst I cannot categorically say this is down to the “excessive” stress cause by the daily advance and rotate i.e. I see that if you keep tinkering with something by moving it daily, you are likely to loosen it and accelerate the normal wear and tear duration? Logical?

A week ago, whilst in hospital, the specialist stroke nurse was taken aback when I told her I was advancing and rotating the tube daily. I explained this was based on professional advice and a document (NHS if I am not mistaken) saying the same and she said she was not aware of such guidelines and she would check with her colleagues.

I was shocked! How can there be such conflicting advice on the same topic and with not to many variables in the equation?

The Stroke Nurse later confirmed that her colleagues were also not aware of the daily routine and told me to revert back to the weekly.

Why am I telling you this?

A cautionary tale – I believe though I cannot prove it, that the switch the daily advance and rotate has contributed to the deterioration of the PEG tube and the associated issues Mum is now experiencing.

Maybe I should have stuck with my gut instinct and not switched to the daily routine. But worryingly for me, no one picked up on it or has questioned it until now. So what is the truth?

How are you supposed to be an expert on all things?

See also related topic:
PEG tube Feed Duration Update .

Stay well, stay safe.

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