Concierge gastroenterology · UK
PEG feeding tube - placed properly, decided properly.
A feeding tube through the abdominal wall into the stomach, placed endoscopically under sedation in twenty to thirty minutes. A consultant gastroenterologist, dietitian and speech-and-language input before the procedure, and honest advice when a tube is not the answer.
Why patients choose us
- 01
A consultant gastroenterologist, in an endoscopy unit
PEG insertion by an experienced consultant endoscopist with a trained assistant - in a JAG-accredited unit with full monitoring, never an ad-hoc list.
- 02
The feeding decision made properly, first
A PEG is a decision about nutrition, prognosis and quality of life - not just a tube. Dietitian and speech-and-language input come before the endoscopy, not after.
- 03
Independent, and free
We are paid by no clinic, so the recommendation - including whether a nasogastric tube or no tube at all fits better - is impartial and costs you nothing.
Indicative pricing
What private PEG insertion costs in the UK.
Indicative ranges across our partner endoscopy units, including sedation. Send the details and we quote firm figures across two or three options, with cover checked.
In short
PEG insertion in our network: £2,500–£4,500, home the same day or after one night.
| Procedure | Indicative range | Typical duration | Stay |
|---|---|---|---|
| PEG insertion (endoscopic, with sedation) | £2,500–£4,500 | 20–30 min | Day-case or 1 night |
| PEG insertion with overnight stay and feed initiation | £3,500–£6,000 | 20–30 min | 1–2 nights |
| PEG replacement (balloon tube change) | £800–£1,800 | 15–20 min | Same day |
| Radiologically inserted gastrostomy (RIG) where endoscopy unsuitable | £3,000–£5,500 | 30–45 min | Day-case or 1 night |
| Dietitian-led home feeding set-up (first month) | £400–£900 | - | Ongoing |
| Gastroenterology consultation only | £250–£400 | 30–45 min | Same visit |
Prices vary by unit, by whether an overnight stay and feed initiation are included, and by the ongoing home-feeding support package. PEG insertion is routine and free on the NHS; families most often come to us for speed ahead of cancer treatment, or for a planned admission around a complex home situation. We come back with a firm quote within one working day.
The problem
The right decision, the right timing, and support that lasts beyond the tube.
PEG care goes wrong in three places - a rushed decision, a mistimed procedure, and families sent home with a tube and no training. We fix all three before the endoscopy is booked.
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Should there be a tube at all?
In advanced dementia and near the end of life, a PEG often adds burden without benefit. We arrange the senior conversation first - and sometimes the answer is no.
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Timing decides the risk
In MND, breathing strength; in head-and-neck cancer, the radiotherapy start date. Placed at the right moment, a PEG is a small procedure. Left late, it is not.
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The tube is the easy part
Flushing, feed regimens, skin care, the advance-and-rotate habit. The training and dietitian follow-up are what make life with a PEG workable - so we build them in.
The journey
From enquiry to confident feeding - what happens, in order.
One team from first message through assessment, endoscopy, feed initiation and stoma care at home.
Phase 1 · Before the procedure
Assessment, decision-making and preparation
Phase 2 · On the day
Endoscopy and recovery
Phase 3 · After
Feeding, training, follow-up
- 01
Before
You tell us what is going on
A short, confidential form - usually completed with a relative or carer. The swallowing problem, the underlying condition, current feeding, and what the patient themselves wants.
- 02
Before
We come back with a recommendation
Within one working day: whether a PEG is genuinely the right route, the right unit and consultant, and an indicative price including the feeding plan that follows.
- 03
Before
Nutrition and swallowing assessment
A dietitian quantifies needs; a speech-and-language therapist assesses the swallow. For MND, stroke and head-and-neck cancer, timing against treatment matters and is planned here.
- 04
Before
Consent, capacity and preparation
A frank discussion of benefit and burden - and where capacity is limited, a best-interests process done properly. Antibiotic prophylaxis arranged, blood thinners reviewed, fasting from midnight.
- 05
On the day
The endoscopy and tube placement
Sedation, a gastroscope into the stomach, the stomach inflated against the abdominal wall, a small skin incision, and the tube drawn into place - 20–30 minutes in all.
- 06
On the day
Recovery and first use
Observation for four to six hours. Water via the tube the same day in most units, feed built up from the next morning under the dietitian’s plan.
- 07
After
Stoma care, training and follow-up
You and your carers are taught flushing, feed connection and skin care. Stoma review at 1–2 weeks, dietitian follow-up ongoing, and a plan for tube replacement at 1–2 years.
Typical end-to-end: 1–2 weeks from enquiry to insertion. Full feeds established: within 2–4 days.
When it helps
When a PEG is the right step.
The situations we see most, plus the one that deserves a conversation rather than a procedure.
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Stroke with persisting dysphagia
When a safe swallow has not returned after the early weeks and nasogastric feeding cannot continue indefinitely.
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Motor neurone disease
Placed proactively, while breathing is still strong enough for sedation - timing is everything and is planned with the MND team.
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Head and neck cancer
Before or during radiotherapy and chemotherapy, when swallowing is expected to become too painful or unsafe to maintain nutrition.
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Parkinson’s and progressive neurology
Advanced Parkinson’s, multiple sclerosis or dementia with unsafe swallow - always weighed carefully against benefit and burden.
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Long-term nasogastric feeding
An NG tube that keeps falling out or has been in place beyond four to six weeks - a PEG is safer and far more comfortable.
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Oesophageal obstruction
Strictures or tumours that block swallowing while the stomach itself works normally.
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Severe aspiration
Recurrent chest infections from food and drink entering the lungs, confirmed on swallowing assessment.
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Red flag: feeding decisions near the end of life
In advanced dementia and dying patients, PEG feeding often adds burden without benefit. This deserves a senior, honest conversation - not a booking form.
Tube options
Technique and tube both depend on the indication.
What each option involves - how the tube is placed (pull, push, radiological) and what it can later become (balloon tube, button, jejunal extension).
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Pull-technique PEG
The standard method: the tube is drawn down through the mouth and out through the abdominal wall, held by an internal bumper. Robust, and lasts one to two years.
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Push (introducer) PEG
Placed directly through the abdominal wall over a guidewire - preferred in head-and-neck cancer to avoid dragging the tube past a tumour.
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Radiologically inserted gastrostomy (RIG)
Placed under X-ray guidance without an endoscope - the alternative when the gullet cannot be passed or sedation must be minimised.
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Balloon gastrostomy (replacement tube)
Once the tract has matured, the original PEG can be swapped for a balloon tube - changed simply at the bedside every few months.
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Low-profile button device
A discreet skin-level device favoured by younger and active patients - the feeding set clicks on only when needed.
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PEG-J (jejunal extension)
A fine extension through the PEG into the small bowel, for severe reflux, gastroparesis or repeated aspiration on gastric feeding.
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Nasogastric tube (the comparator)
Right for short-term feeding - up to four to six weeks. Beyond that, a PEG is more secure, more comfortable and kinder to the nose and throat.
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No tube - supported oral feeding
Sometimes the honest answer: careful hand feeding, texture modification and comfort-focused care. We say so when it is.
Our vetted UK network
A small panel of endoscopy units, we picked them.
Consultant gastroenterologists and nutrition teams across London and the major UK cities. Introductions are made privately, once we understand the case.
Selection criteria
How we choose every endoscopy unit in our network.
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JAG-accredited endoscopy units with consultant-delivered PEG lists
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Dietitian and speech-and-language assessment built into the pathway, before endoscopy
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Nutrition support teams for home feed set-up, training and ongoing review
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Clear ethics and best-interests processes where capacity is in question
Safety and recovery
What to expect afterwards - honestly.
PEG insertion is quick and well-tolerated. The things worth planning are infection prevention, the daily tube-care habits, and knowing the few symptoms that must never wait.
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Sedation, not general anaesthetic
PEG insertion uses conscious sedation and local anaesthetic to the skin. Frailty and breathing problems are assessed beforehand - in MND this is the critical timing question.
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Wound infection is the commonest issue
Skin infection around the stoma affects up to one in five without prophylaxis; a single antibiotic dose beforehand roughly halves it. Redness beyond the first days deserves review.
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Peritonitis and perforation are the serious rarities
Leakage into the abdomen or injury to bowel occurs in well under 1 percent. Worsening abdominal pain or fever in the first days is never ignored - same-day review, always.
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Bleeding
Minor oozing at the site is common and settles with pressure. Significant bleeding needing intervention is rare; blood thinners are managed before the procedure.
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Buried bumper - the long-term one to know
If the internal bumper is pulled too tight for months, it can embed in the stomach wall. Daily advancing and rotating of the tube - taught at discharge - prevents it.
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Tube blockage and leakage
Blockages are almost always a flushing problem: water before and after every feed and medicine. Persistent leakage around the stoma needs a tube check, not a bigger tube.
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Aspiration does not disappear
A PEG feeds the stomach; it does not stop saliva or reflux reaching the lungs. Feeding position and rate matter, and in high-risk cases a PEG-J is considered.
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Living with a PEG
Showers, clothes and most activities are unaffected once healed. Many people feed overnight and are free of the pump all day. A PEG can be removed if swallowing recovers - the hole simply closes.
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Red flags after insertion
Fever, spreading redness, severe abdominal pain, fresh bleeding, or a tube that falls out in the first four weeks need the endoscopy team or A&E the same day - a mature tract this early does not exist.
Reading your procedure note
Your procedure note in four parts. Read the last one first.
Whichever technique was used - pull, push or radiological - the note the endoscopist sends keeps to the same shape.
A quiet reminder
Endoscopy language is precise and can read coldly - we translate it for you.
If you would like us to talk you and your family through the note and the feeding plan, just ask.
- 01 Header
Indication, technique and tube
Why the PEG was placed, pull or push technique, and the exact tube - make, size in French, and bumper or balloon type.
- 02 Technique
Endoscopy findings and placement
What the gastroscope saw on the way down, the transillumination check, and how the position was confirmed before the team finished.
- 03 Findings
Immediate aftercare instructions
When water and feed can start, the sedation recovery advice, and the first stoma-care steps for the ward or home team.
- 04 Impression
Feeding plan and follow-up
Read this first: the dietitian’s feed regimen, the stoma review date, the daily advance-and-rotate instruction, and when the tube is due for planned change.
Recognised by major UK insurers
PEG insertion is usually covered when part of treatment for an insured condition - head and neck cancer most reliably. Long-term home feeding costs are often excluded. We confirm both before booking.
Frequently asked
Everything we get asked about PEG feeding.
Quick answers on the procedure, feeding, tube care, cost - and the decisions families find hardest.
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What exactly is a PEG?
A percutaneous endoscopic gastrostomy is a soft feeding tube that passes through the skin of the abdomen directly into the stomach, placed with the help of a gastroscope under sedation. It allows liquid feed, water and medicines to be given when swallowing is unsafe or impossible, and it sits discreetly under clothing between feeds.
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Is having a PEG put in painful?
The procedure itself is done under sedation with local anaesthetic to the skin, and most people remember little of it. Expect soreness at the site for a few days, managed with simple painkillers. The commonest description afterwards is of a bruised feeling rather than sharp pain - anything worse, particularly worsening abdominal pain with fever, needs same-day review.
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How soon can feeding start after PEG insertion?
Sooner than most families expect. Evidence supports using the tube within hours: most UK units give water at around four hours and start feed the same evening or the following morning, built up over a few days to the dietitian’s target regimen.
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How long does a PEG last, and can it be removed?
The original tube typically serves one to two years before a planned change, and once the tract has matured it can be swapped for a balloon tube or a discreet skin-level button in minutes. If swallowing recovers - as it can after stroke or cancer treatment - the tube is simply removed and the opening usually closes within days.
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How much does private PEG insertion cost in the UK?
Typically £2,500–£4,500 for the procedure with sedation as a day-case, or £3,500–£6,000 with an overnight stay and feed initiation. Home feeding set-up with dietitian support adds £400–£900 for the first month. On the NHS the procedure is routine and free, but private routes are often chosen for speed - particularly ahead of cancer treatment. We confirm firm figures within one working day.
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Is a PEG the right thing in advanced dementia?
Usually not - and this is one of the most important honest answers in this field. In advanced dementia, tube feeding has not been shown to prolong life, prevent aspiration or improve comfort, and UK guidance favours careful hand feeding focused on comfort. Every case deserves a senior clinical conversation involving the family, and we will arrange exactly that rather than a procedure.
Related treatments
Looking for something else?
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Gastroscopy
The camera test behind PEG placement.
Learn more -
Swallowing assessment
Speech-and-language evaluation of dysphagia.
Learn more -
Colonoscopy
Lower-GI endoscopy, arranged privately.
Learn more -
Stroke
The condition most often behind new dysphagia.
Learn more -
Dietitian support
Nutrition planning for tube and oral feeding.
Learn more -
All tests & procedures
Every test and procedure we arrange.
Learn more