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A Review of Complications, Outcomes, and Technical Considerations of Endoscopically Placed Feeding Tubes in Obesity

  • Nutrition and Obesity (C Newberry, Section Editor)
  • Published:
Current Treatment Options in Gastroenterology Aims and scope Submit manuscript

Abstract

Purpose of Review

As the prevalence of obesity continues to rise, so does the need for enteral access for nutrition in patients who are overweight or obese. While gastrostomy tube placement is considered a safe procedure with a low complication rate in nonobese populations, there is limited literature regarding the outcomes and technical considerations of tube placement and nutritional feed selection in patients who are overweight or obese. In this review, we aim to discuss the outcomes of tube placement, technical considerations to optimize success, and selection of enteral feeds in patients who are overweight or obese and require the placement of a percutaneous endoscopic gastrostomy/jejunostomy tube (PEG/PEJ).

Recent Findings

Technical success rates remain high for PEG placement in the obese population and comparable to the nonobese population. While complication rates are slightly higher in the obese population compared to the nonobese population, the difference is not significant. This contrasts with PEJ placement, which has lower technical success rate in obese versus non obese patients. Once enteral access is achieved, patients with obesity benefit from starting nutritional rehabilitation with a high protein, low-calorie feed.

Summary

Patients with obesity present a unique challenge as factors such as body habitus create challenges in transillumination, finger indentation, and needle puncture; BMI should not be a contraindication to PEG placement.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA

    Ankoor Patel MD & Keerthana Kesavarapu MD

  2. Internal Medicine, Robert Wood Johnson Medical School, Rutgers Biomedical and Health Sciences (RBHS), Rutgers University, New Brunswick, NJ, USA

    Ankoor Patel MD

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All authors worked in all 4 aspects of authorship as per ICMJE guidelines.

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Correspondence to Keerthana Kesavarapu MD.

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Ankoor H Patel declares that he has no conflict of interest. Keerthana Kesavarapu declares that he has no conflict of interest.

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Patel, A., Kesavarapu, K. A Review of Complications, Outcomes, and Technical Considerations of Endoscopically Placed Feeding Tubes in Obesity. Curr Treat Options Gastro 21, 48–56 (2023). https://doi.org/10.1007/s11938-023-00407-3

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