We have received a request from your referring doctor for you to have a P.R.G. This leaflet is designed to give you some information about the procedure, to help you prepare for your examination and to give you some idea of what to expect when you attend.

Q1. What is a Percutaneous Radiological Gastrostomy (PRG)?

A1. A P.R.G. is a short tube, flush with the tummy that enables you to be fed directly into your stomach without taking food through your mouth.

Q2. Why do I need It?

A2. Your doctor has recommended that you have a P.R.G. When you are not able to eat and drink enough, the best way to have liquid nourishment, fluid and medication is through a Gastrostomy tube.

Q3. How is this tube put in?

A3.

The day before the procedure, a thin, soft tube will be put down the nose into the stomach.
A liquid, which shows up on an X-ray, will be put through this tube to enable the doctor to see where your bowel is so this can be avoided.
On the day of the procedure you will go to the X-ray department and once lying on the X-ray table you will be given a sedative injection in your arm to relax you and make you sleepy.
Local anaesthetic (see below) is injected into the selected site and four special stitches are put inside your stomach. These are removed in 7-10 days.
The tube is placed between these stitches using X-ray guidance.
Once you return to the ward the Naso-gastric tube may be removed unless the doctor states otherwise.
In your stomach there will be a small balloon filled with water, which stops your tube from falling out. This water will need to be changed every 10-14 days, which will be done by your Community Nurse.
When you are to have a feed a feeding tube will be attached to your tube through which the feed can be given.
The type of tube you have put in will usually be a low profile device or “Button” – called this as it sits flat on the abdominal wall.

Q4. Local Anaesthetic

Your radiologist will ask you to keep quite still while the injections are given.
You may notice a warm tingling feeling as the anaesthetic begins to take effect.
Your procedure will only go ahead when you and your radiologist are sure that the area is numb.
If you are not having sedation, you will remain alert and aware of your surroundings. A screen shields the operating site, so you will not see the procedure unless you want to.
Your radiologist is always near to you and you can speak to him/her whenever you want to.

Q5. Can anything go wrong?

A4. Occasionally there may be leakage of stomach contents into the abdominal cavity causing infection. Infection can also occur where the tube passes through the skin. An antibiotic is given to reduce the risk and treat any infection.

Inhalation of stomach contents can result in Pneumonia, which would need antibiotic treatment.

Bleeding can occur where the tube passes through into the stomach. The risk of any of these complications being fatal is small (1 in 100 (1%))

Q6. What happens next?

A5. While still in hospital you will be shown how to care for your button and you will start receiving feeds through it.

The Dietician will choose the best feed for your individual needs and work out your feeding regime and you or your carer will be taught how to give the feeds.

Q7. What can I put through the button?

Your feed
Medication in liquid form
Water

Q8. What else do I need to know?

A7. It takes two weeks for the channel or ‘stoma’ to form around the button, there may be a small amount of discharge during this time and a small dressing may be required.

You will be able to shower soon after the button is inserted and after two weeks you may have a bath or even go swimming.

You can go out and will find the button is unobtrusive under your clothes.

Q9. How long will the button last?

A8. The button is designed to last about six months before it needs to be changed, This can be done without the need for another visit to the x-ray department and if it is no longer needed it can easily be removed.

Many people have benefited from having a feeding tube placed directly into their stomach and enjoy the freedom it provides. Using the button may seem strange at first but you will soon adapt to a new way of life. There is no need to worry as there will be plenty of help and support for you. A special team has been set up to care for you after your button has been inserted. The team includes:-

Stephanie White, Clinical Liaison Nurse (PEG Nurse – [Percutaneous Endoscopic Gastrostomy])
Margaret Atkins, Clinical Liaison Nurse (PEG Nurse)
Sue Clark, Head of Speech Therapy
Mr Alan Torrance, Head Dietician
Dr P Haslam, Consultant Radiologist
Dr K Matthewson, Consultant Gastroenterologist

If you need further information please contact us on the following number,

0191 2825655 and ask for the PEG nurse.

Q10. I need an ambulance. Do you arrange one?

A9. If you need an ambulance, you must ask your GP Surgery to arrange one, but you will need to give them three working days notice. Please inform the department if you are arriving by ambulance as we will arrange your appointment time to fit with ambulance arrivals.

Q11. What if I have any comments, suggestions or complaints?

A10. Should you have any suggestions or concerns, please make these known to the person conducting your examination on the telephone number, as below, or by letter addressed to the hospital you are attending your appointment:

Monday – Friday: 8.45am – 5.00pm

The Departmental Manager The Departmental Manager

Leazes Wing Xray Department Main Xray Department

Royal Victoria Infirmary Freeman Hospital

Richardson Road High Heaton

Newcastle upon Tyne NE1 4LP Newcastle upon Tyne NE7 7DN

Tel: (0191) 282 5624 Tel: (0191) 223 1012

All Newcastle Hospitals: Switchboard Tel: (0191) 233 6161

If you need to turn to someone for on-the-spot help, advice and support, please contact the Patient Advice and Liaison Service (PALS) on:

Freephone 0800-032-02-02

Due to the transformations of the Newcastle Hospitals, please see ' Patient and Visitor Guides' to check map details for updates.

Alternatively, please see local map details on how to get to the new Victoria Wing, RVI and the Freeman Hospital. The Freeman Hospital is to the east of the City of Newcastle upon Tyne with public transport services close by. Buses are available to and from the city centre direct to the main hospital entrance. A clearly sign-posted car park is provided for patients and visitors for which a charge applies.

All patient information is available in large print size for people with visual impairments or partial vision. Please click on the link above, 'large print size' to view and print the document or alternatively, please click on the large 'A' at the top of the screen to read this information on-line.

Information produced by: Dr J Rose, Clinical Directorate of Radiology
Reviewed: November 2009
Next Review: November 2012