Professional Guide to Percutaneous Gastrostomy Materials: Types, Selection, and How to Prevent Clinical Failures

Percutaneous endoscopic gastrostomy (PEG) is a widely used method for delivering enteral nutrition when oral intake is not possible or safe over the long term, provided the digestive tract remains functional.

Unlike nasogastric tubes, PEG involves placing the feeding tube directly into the stomach through the abdominal wall using endoscopy. This approach avoids irritation in the throat, reduces the risk of local complications from tube friction, and is less psychologically distressing for the patient, as the tube remains hidden under clothing.

While PEG is a standardized procedure with relatively few complications—most commonly, infection around the stoma—its long-term success depends heavily on the correct selection, use, and maintenance of the materials involved.

Gastrostomy Tubes: Types, Materials, and Technical Differences

The key component in any PEG kit is the feeding tube. This flexible conduit connects the stomach to the outside of the body, allowing for the delivery of food, fluids, and medications. Tubes may be single or multi-lumen depending on whether they’re intended for gastric or gastrojejunal use. They feature an internal retention device (either a rigid bumper or inflatable balloon) to secure placement inside the stomach, along with an external fixation plate to hold the tube in place on the skin.

PEG tubes are inserted directly into the stomach and are used to administer nutrition, fluids, and medications. They’re typically recommended for patients requiring long-term nutritional support and who are at low risk of aspiration.

Depending on their length and external design, PEG tubes fall into two main categories:

• Traditional long tubes are the most commonly used during initial endoscopic placement. Usually made from medical-grade silicone, they extend visibly from the abdominal wall and feature two ports: a gastric port that opens into the stomach and a balloon port for inflating the balloon with water. These tubes are easy to handle and connect well with feeding systems or syringes.

Danumed® gastrostomy tube with balloon retention for long-term enteral feeding.

• Low-profile “button” tubes sit flush against the skin and are more discreet. They can replace traditional tubes once the stoma has healed (after 4–6 weeks). They’re especially suitable for patients who need long-term feeding, are prone to accidental tube removal, such as children or adults with cognitive impairment, or who lead more active lifestyles. These tubes require an adapter to connect with feeding systems, but offer improved comfort and aesthetics.

Danubutton® gastrostomy button.

Key Criteria for Material Selection in Hospital Settings: Compatibility, Quality, and Standards

In clinical environments, selecting PEG materials should align with both medical and regulatory requirements. Compatibility with standard devices such as ENFit® syringes and feeding pumps is essential to prevent connection errors and ensure safe administration. All feeding tubes must comply with up-to-date ISO standards, and hospitals should ensure products carry CE marking or equivalent certifications.

Common Mistakes in PEG Material Selection and Handling—and How to Avoid Them

• Using tubes that are not suitable for the patient’s anatomy or needs. Tubes that are too short create excessive tension between internal and external retention points, increasing the risk of buried bumper syndrome, which may require surgical intervention.
• Tube blockage caused by non-homogeneous feeding formulas or poorly crushed medications. To prevent this, use standardized enteral formulas at room temperature and avoid blending regular foods. If blockage occurs, regular water flushes using appropriate syringes can help maintain patency.
• Defective balloons potentially lead to leakage around the stoma or accidental tube dislodgement. 
• Poorly designed connectors can also allow air or bacteria to enter the system, compromising safety.

Ultimately, the effectiveness of PEG-based enteral nutrition relies not only on technical precision but also on in-depth knowledge and the quality of the materials used. At Bexen Medical, we are committed to supporting better clinical practice and patient safety. Our products are designed with functionality, durability, and reliability in mind.

Explore our full range of enteral nutrition products and find the right solution for your clinical needs.

References

González N, Zugasti Murillo A, Casanueva F, Sanz-Paris A. Recomendaciones sobre la utilización de la gastrostomía endoscópica percutánea (GEP) en el paciente adulto. Nutr Hosp [Internet]. 2010 Oct [cited 2025 May 29];25(5):735–47. Available from: https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082010001000010

Molina Villalba C, Vázquez Rodríguez JA, Gallardo Sánchez F. Gastrostomía endoscópica percutánea. Indicaciones, cuidados y complicaciones. Medicina Clínica 2019; 152(6):229-236. doi: 10.1016/j.medcli.2018.09.008.

St. Jude Children’s Research Hospital. Tipos de sondas de alimentación y dispositivos [Internet]. [cited 2025 May 29]. Available from: https://together.stjude.org/es-us/patient-education-resources/medical-devices-supplies/types-of-tubes-and-devices.html