What is the incidence of gastric ulceration with PEG tube placement?

• A. 0.3-2.5% of cases
• B. 0.01-0.1% of cases
• C. 3-5% of cases
• D. 10-20% of cases

Answer: (A)

Gastric ulceration after PEG tube placement is an uncommon complication, occurring in roughly 0.3–2.5% of cases. It happens when the tube and internal bumper press against or constantly irritate the gastric mucosa at the gastrostomy tract, leading to localized ulceration over time. Clinically, patients may develop new or worsening epigastric pain, occult or overt bleeding, or feeding intolerance, often after weeks to months of tube use. If suspected, endoscopic evaluation is used to confirm and to guide treatment, which typically includes proton pump inhibitor therapy, ensuring the tube isn’t applying excessive pressure or irritating the mucosa, and addressing any bleeding. In many patients, ulcers heal with medical management and proper tube care; more invasive interventions are reserved for persistent or severe cases.

The other reported percentages are higher or lower than what is commonly seen with PEG; the incidence is not as high as 10–20% or 3–5%, and it isn’t as low as 0.01–0.1%.