title: Pain and Anxiety Experienced by Patients Following Placement of a Percutaneous Endoscopic Gastrostomy.
abstract: BACKGROUND
  Abdominal pain following percutaneous endoscopic gastrostomy (PEG) placement is a recognized complication. However, the prevalence and degree of severity of pain are poorly characterized. We assessed abdominal pain and anxiety levels associated with PEG placement in communicative and noncommunicative patients.
  
  
  METHODS
  A prospective questionnaire assessed patients' anxiety and abdominal pain 1 hour before, 1 hour after, and 24 hours after PEG placement using 11-point Likert-type scales. Patients were followed up until pain had resolved. Procedural data, analgesia requirements, and complications were recorded. For analysis, patients were divided into 2 groups: communicative (able to self-assess) and noncommunicative (clinician assessed).
  
  
  RESULTS
  Seventy consecutive patients were assessed. Of the 49 self-assessed patients, 11 (22%) reported immediate pain, 32 (65%) reported pain at 1 hour (24 mild, 5 moderate, 3 severe), and 40 (82%) reported pain at 24 hours. Pain most commonly lasted between 24 and 48 hours (25 patients). Of the 21 clinician-assessed patients, only 1 was deemed to have pain, and this was at 24 hours. Four (6%) patients were admitted with pain. There was no relationship between preplacement anxiety scores and postplacement pain scores.
  
  
  CONCLUSIONS
  Abdominal pain after PEG placement pain is common but resolved by 48 hours in most patients. In patients able to communicate, clinicians scored pain lower compared with patients' scores. It is likely that pain is not identified in patients unable to communicate. Patients need to be better informed about the possibility of postprocedural pain and routinely offered access to appropriate analgesia.
authors.affiliation: Department of Gastroenterology, Derriford Hospital, Plymouth, UK.
authors.forename: Philip
authors.initials: P
authors.lastname: Oppong
authors.affiliation: Department of Gastroenterology, Derriford Hospital, Plymouth, UK.
authors.forename: Narrie
authors.initials: N
authors.lastname: Pitts
authors.affiliation: Department of Dietetics, Derriford Hospital, Plymouth, UK.
authors.forename: Vicky
authors.initials: V
authors.lastname: Chudleigh
authors.affiliation: Department of Gastroenterology, St Marks Hospital, London, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Latchford
authors.affiliation: Department of Oncology, Derriford Hospital, Plymouth, UK.
authors.forename: Amy
authors.initials: A
authors.lastname: Roy
authors.affiliation: Department of Anaesthesia, Derriford Hospital, Plymouth, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Rocket
authors.affiliation: Department of Gastroenterology, Derriford Hospital, Plymouth, UK sjl@doctors.org.uk.
authors.forename: Stephen
authors.initials: S
authors.lastname: Lewis
mesh_terms: D000368:Aged; D001007:Anxiety / Q000209:etiology / Q000503:physiopathology*; D015992:Body Mass Index; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000503:physiopathology*; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology*; D011446:Prospective Studies; D011795:Surveys and Questionnaires
keywords: abdominal pain; endoscopic gastrostomy; enteral nutrition