To PEG or not to PEG.

Patients with adequate intestinal function who are unable to eat may benefit from enteral tube feeding. Percutaneous endoscopic gastrostomy (PEG) is preferred when prolonged treatment is envisaged. PEG feeding will reduce morbidity and mortality in many such patients by reversing malnutrition. The increasing numbers of elderly patients with chronic diseases have resulted in an increased demand for PEG placement that has stretched resources. Many patients who are referred for PEGs are frail and the procedure is associated with complications. Careful management and support for the carers in the community are essential. Not all patients benefit from PEG feeding. The aim must be an improvement in the quality of life, not a prolongation of terminal disease.