title: Indications for percutaneous endoscopic gastrostomy in complex tuberculosis patients.
abstract: OBJECTIVE
  Percutaneous endoscopic gastrostomy (PEG) is a widely used method for providing long-term administration of tube feeding. Different indications in relation to diseases, impairments and nutritional factors for PEG placement have been mentioned in guidelines. Treatment with PEG has not been described previously for tuberculosis (TB). Our aim was to identify and describe indications and contributing factors for PEG placement in TB patients.
  
  
  METHODS
  A retrospective medical record review was conducted of 32 TB patients who required PEG from March 1996 to April 2004. Indications and contributing factors for PEG placement were analysed.
  
  
  RESULTS
  PEG placement was based on three different indications. In 18 patients, PEG was used to administer tube feeding, in 4 patients anti-tuberculosis drugs were administered and in 10 patients both tube feeding and antituberculosis drugs were administered. Contributing factors for PEG placement were swallowing disabilities, weakness, anti-tuberculosis drugs and their side effects, pain of neuralgic origin, hiccups and refusal of food and drugs.
  
  
  CONCLUSIONS
  In TB, imminent and overt malnutrition, as well as the administration of drugs with a curative aim, are new indications for PEG placement. The use of PEG can overcome various problems in TB treatment and prevent treatment default.
authors.affiliation: Tuberculosis Center, University Medical Center Groningen, University of Groningen, PO Box 30 002, 9750 RA Haren, The Netherlands. g.warmelink@cvr.umcg.nl
authors.forename: G
authors.initials: G
authors.lastname: Warmelink
authors.forename: B J J
authors.initials: BJ
authors.lastname: Poels
authors.forename: R
authors.initials: R
authors.lastname: van Altena
authors.forename: F T M
authors.initials: FT
authors.lastname: Peters
mesh_terms: D000328:Adult; D000368:Aged; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D005773:Gastroscopy; D005774:Gastrostomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014376:Tuberculosis / Q000150:complications / Q000178:diet therapy*