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How do you keep food down with PEG?

cureitall66's picture
cureitall66
Posts: 837
Joined: Aug 2012

Hi Everyone,

Well last week was the PEG insert. He is being fed via gravity bag. Does meds by syringe.
Does his flushing of water before and after. First couple days was able to hold down the food (called 2.0) and now he throws up everytime. Also can't hold his meds down with syringe. Do we know why this could be? He's making sure he sits up while eating and 30 min or so after. We're thinking of calling the weekend dietitian. Any suggestions?

BTW...they put him on this 2.0 rather than boost or ensure because his stomach had shrunk so much and didn't feel he could handle that.

Thank you.

Cris

George_Baltimore's picture
George_Baltimore
Posts: 303
Joined: Jun 2009

Is meant to be a supplement not a replacement for food. Whatever 2.0 he is using probably meets every nutritional requirement that his body needs every day. Read the labels of both and you will see there is a huge difference. As far as throwing up, when I was going through chemo and rads, I threw up almost constantly. I doubt that it's the liquid food that's causing it. It's probably the chemo. Maybe an anti-nausea drug will help but don't expect miracles. It will get better with time.

luvofmylif
Posts: 344
Joined: Sep 2012

I was thinking mabe smaller doses at a time of the tube feeding. Gradually build him up to the volume he is supposed to have. His system is not used to that much at once. Hope he starts doing better soon. You are near the end of treatment as are we. We have 9 more rads and 1 more chemo. Hanging in there one day at a time.

Joan

phrannie51's picture
phrannie51
Posts: 3601
Joined: Mar 2012

Smaller portions, just more often. I don't think it's the actual food or the PEG that is causing him to throw up...rads and chemo are the most likely culprits...I don't know how big of can 2.0 is in, I've never heard of it...or how thick it might be. For me, once I reached a certain stage in treatment, mixing my boost with whole milk helped me, plus I'd drink whole milk all by itself to get the calories and the hydration....I'd spread out two 8 oz Boosts, and 2 glasses of milk through out the day.....I know he needs more than I did, but spreading them out might be just what he needs.

p

cureitall66's picture
cureitall66
Posts: 837
Joined: Aug 2012

He wasn't really throwing up much until the peg/feeding started. But, maybe since we are getting farther to the end of tx he's getting more sensitive to the rad/chemo.

I thought the same thing about dividing up the feedings. Weekends aren't bad to do that, however, during the week driving to tx everyday (2 1/2 hrs one way) is getting difficult to work around. He gets home late and it forces him to catch up because he's hungry. Well....we are into week six this Monday...YAH!!!

Thanks for your reply everyone.

Cris

blackswampboy's picture
blackswampboy
Posts: 341
Joined: Jul 2012

my understanding is that 1.0, 1.5, 2.0 designation is based on the number of calories per can. 2.0 should be quite high, like 500 cal./can. 1.5 is less, like 335 per can.
I wanted to get 2.0, but they wouldn't give it to me. even going from 6 to 7 cans of 1.5 per day, had to get a new prescription. that was baffling to me, since I never had nausea.
anyway, apparently controlling caloric intake is important. maybe he'd find 1.5 easier to handle?

zaac23
Posts: 24
Joined: Dec 2010

I had similar probs and onc nurse said even if it takes a hour to ingest 8 oz into tube you will get what you need. she said something about i did't look like i was going anywhere for awhile. try putting meds in food as well.check whether doc ok w/ mixing meds

cureitall66's picture
cureitall66
Posts: 837
Joined: Aug 2012

They told us to do the meds with syringe and food through gravity bag. He's been taking the meds first thing in the morning before food....I'm thinking an empty stomach with meds is not a good way to do it. But going to check out details on that.

Thanks for your reply.

Hard12Find
Posts: 197
Joined: Sep 2012

Volume and speed of flow made all the difference for me, however at some point my body said screw this canned stuff you need food. I use a blended gruel of malt o meal, cream of wheat, broths, anything i can get through the tube, smoothies, and it made it a lot more bearable.,
I had nausea bad pretty much every day, and only have 5 more radiations to go, I try to limit my meds to absolute necessary, pain and anti nausea, nothing extra to stir the pot.
Slower flushes.

Another option is the food pump, to put in really small quantities even while you sleep, however with me I would wake up overful, and off to the bathroom.

Work with your Docs on managing nausea, scopalamine patches, fentenyl suppossitories, ondansitron, corticosteroids, whatever it takes...save his weight now as I lost 50 + pounds.
Jim

phrannie51's picture
phrannie51
Posts: 3601
Joined: Mar 2012

the Home Health nurse told me if I had trouble with nausea, they could get me a pump, and I could be fed all thru the night as getting some during the day. The pump can be set to deliver so much per hour...I didn't have much trouble so never got one, but I was relieved to hear about it when I first started using my tube...knowing all the options makes me feel more secure :).

p

cureitall66's picture
cureitall66
Posts: 837
Joined: Aug 2012

Good to know there are other options. We'll check on the pump Monday. Until then, we're going to do more feedings in smaller amounts at a time....see if that helps out.

Thanks for the replies.

D Lewis's picture
D Lewis
Posts: 1518
Joined: Jan 2010

I ate three times during the day - one can of food each time, and I'd set the pump rate so that it flowed in over a 45-minute period. At night, I'd fill the feed bag with five cans of the stuff, and set it to flow over a seven or eight hour period. That way, the alarm that sounded when the bag was empty would serve as my wake up alarm. It was a slow enough rate that it never made me sick. Worked very well for me.

Just about three weeks after chemo/rads ended, I started feeling a whole lot less sick to my stomach, and discovered that I was able to 'down' a whole can of food within just about a five or ten minute period and it no longer made me sick.

Deb

MarineE5
Posts: 744
Joined: Dec 2005

Cris,

Just a note on my part, what ever goes thru the Peg should be no colder then room temperature. We are putting water and nutrition directly into our stomachs and we have a reaction to it such as cramps and vomiting. Of course, the treatments could very well be the problem as mentioned above, but I didn't see temperatures of the fluids going in mentioned. Just a thought.

My Best to Both of You and Everyone Here

cureitall66's picture
cureitall66
Posts: 837
Joined: Aug 2012

Yes, we've been keeping it at room temperature. Right now we're going to try a feeding over a couple hour span then take meds after the feeding....see if this will stay down.

I guess it's all about trial and error...I just know he's HUNGRY...: )

Thank you for the thoughts...sometimes that helps to mention as our minds can be somewhere else and not even thinking about some obvious things.

Cris

NoDuck
Posts: 132
Joined: May 2012

Hubby had the problems yours is having (except he was never hungry). We second everything everyone else has said and add dilute the 2.0. Dale had Nutren 2.0 and we decided it was too "rich.". I pour the Nutren into a water bottle with about 2-4 ounces of water added. Makes the liquid thinner, goes down tube easier, doesn't seem to make him as queasy. We still do it that way even tho he is now supplementing with real food.

We had a nearly 2 hour one way trip. You must pack food and feed during the trip. Get a cooler, put a couple of water bottles with the food mixture, a couple of bottles of bottle, the syringe and some paper towels. You don't need ice -- nothing needs cooled. We have fed in the parking lot, in the lobby at the cancer center. You do what you have to do.

Regular feedings seemed to help, too . Letting him go too long between meals made his stomach cramp which pulled on the Peg tube.

When we were about where you were in treatment, we were having serious doubts we would make it through. This is the tough part. You will both make it. Prayers for strength and healing.

Deb

VivianLee5689's picture
VivianLee5689
Posts: 546
Joined: Aug 2012

David now has the continuous feed pump. He is set at a rate of 45 ml an hour. It is slower than what the gravity feed bags can do. That seems to help. He was on the scolderam patch and that helped but we had to take it off Friday because of side effects. Unfortunately laser night the nausea came back. As far as him eating more often he needs too. If David has a long day at the doctors he takes a gravity back slams puts some water and food in there. He hangs the bag wherever he can. I've seen him hanging it on a cabinet while in the doctors office. The doctor came in to see him and seemed impressed he found a way to eat. I am worried with him going all day he might get dehydrated and now it's sounds like he risks malnutrition as well. I hope things get worked out soon.

Billie67's picture
Billie67
Posts: 834
Joined: Jul 2012

Helped me. I was vomiting with each feeding no matter how slow we would do it. I ended up in the hospital for a few days due to the dehydration and while there they started me on the pump. As soon as I got home my home nurse met us there and got me started up once again. It made a world of difference.
Good luck to you.
Billie

mikeev
Posts: 19
Joined: Jun 2012

Hy I was having problems with the quantity of ensure 2 cal that I had to have in a day 6 bottles @200mm could not fit it in in 12 hours due to work and other things, was given a pump and overnight feeds of Jevity 1.5cal (1500mm bottle)this worked out better but was very uncomfortable especially when the connections to the Peg came loose and jevity escaped, the smell was terrible and jevity is hard to wash out.

about 4 weeks ago had so many problems with it that I decided to up my intake of normal food started on food smothered with gravy or sauce and am graduly getting to eat with less and less sauce so much that the PEG is coming out tomorrow.

I have given details of what I can eat in the Thread "tongue feels wierd"

Hope you get better with PEG feeds, it is not a nice way to eat but unfortunately a neccessary evil in my case.

Mike

cureitall66's picture
cureitall66
Posts: 837
Joined: Aug 2012

I will look that thread up that you speak of. We're able to keep it down at this point...but still feels like it wants to come up each time. Been diluting it with water...seems to help a bit.

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