Balloon gastrostomy tubes for long-term feeding in the community

Aim: Dysphagic patients with functional guts often receive nutritional and hydration support through enteral feeding tubes. These include percutaneous endoscopic gastrostomy (PEG) and radiologically inserted gastrostomy (RIG) tubes. The balloon gastrostomy tube(BGT) as a primary tube of choice in tube-fed patients, including head and neck cancer patients, offers a new approach to enteral tube feeding in the community. There are complications associated with the use of enteral feeding tubes. This study compared the complication rates and the costs of PEG tubes and BGTs in patients on long-term enteral feeding in the community and looked at the possible use of BGTs as alternative to PEG tubes. Methods: The records of all 15 BGT-fed patients on the caseload and 15 randomly selected PEG tube-fed patients were reviewed. The study was based on two consecutive visits to these patients. Tube and stoma complications were clinically scored in order of increasing severity (0-10) and statistically tested. The prevalence of stoma and tube complications was expressed in percentages. Results: There was no significant difference (P>0.05) in the overall clinical scores between BGT-fed and PEG tube-fed patients at both initial and final visits. However, with respect to specific complications – infected sites, tube dislodgement, overgranulation, and infection with overgranulation – significant differences were observed between the two groups of patients at the initial and final visits. In addition, the total costs of inserting and managing BGTs were significantly higher than those for PEG tubes. Conclusion: Although BGTs may be used as alternative to PEG tubes in patients on long-term enteral feeding in the community, the higher cost of using BGTs over PEG tubes should be considered while selecting feeding tubes for these patients