16 INTRODUCTION Recent interest in the Terri Shiavo case has brought the issue of percutaneous endoscopic gastrostomy (PEG) tubes into active public discussion. What was missing from that debate, however, was a clear discussion of the evidence behind their use. A critical review of the clinical literature reveals that PEG tubes have a limited role in only a few conditions, that even in these conditions their advantage over nasogastric (NG) tubes or medical therapy is questionable, and that they are widely overused in current practice. Those who argue a PEG tube is not a medical intervention have likely never seen one placed. Creating a hole into the stomach through the anterior abdominal wall is surgery, regardless of who does the procedure. As such, it should be performed only if its benefits clearly outweigh its risks and burdens. PEG placement cannot be justified, therefore, without convincing objective clinical evidence of patient benefit. Ultimately, only two patient outcomes matter: making life longer (improving mortality) or better (improving quality of life). The burden of proof of benefit lies not To PEG or Not To PEG NUTRITION ISSUES IN GASTROENTEROLOGY, SERIES #29

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@inproceedings{Parrish2005ToPO, title={To PEG or Not To PEG NUTRITION}, author={Carol Rees Parrish}, year={2005} }