Balancing the Options: NG Tube vs. PEG Tube for Elderly Nutrition

Tube Feeding Dilemma: Is PEG Better Than NG for Seniors With Dysphagia?

Soraya Malik in Health & Wellness November 2025 • 4 min read.

"A pragmatic look at the long-term outcomes of nasogastric versus percutaneous endoscopic gastrostomy tube feeding in older Asians with swallowing difficulties."

Deciding on the best way to provide long-term nutrition for older adults struggling with dysphagia (swallowing difficulties) is a complex challenge. While gastrostomy tube feeding, particularly percutaneous endoscopic gastrostomy (PEG), has gained acceptance in Western countries, many Asian clinicians and caregivers harbor reservations due to concerns about potential complications.

In many Asian healthcare settings, nasogastric (NG) tube feeding remains a common practice for long-term enteral nutrition. However, questions persist about whether NG tubes offer the same benefits and safety as PEG tubes, especially when considering the unique needs and potential risks for older adults.

A recent study published in Nutrition in Clinical Practice sought to shed light on this debate by comparing the clinical and nutritional outcomes of NG versus gastrostomy tube feeding in older Asian patients with dysphagia. Using a pragmatic study design, researchers aimed to provide real-world evidence to guide clinical decision-making in this vulnerable population.

NG vs. PEG Tubes: Understanding the Key Differences & Risks

Balancing the Options: NG Tube vs. PEG Tube for Elderly Nutrition

When an individual has difficulty swallowing, tube feeding becomes necessary to ensure adequate nutrition and medication delivery. Two primary methods exist:

Nasogastric (NG) Tube: A tube inserted through the nose, down the esophagus, and into the stomach. It's a less invasive procedure, making it suitable for short-term feeding.

Pros: Easy to insert, can be placed at the bedside, avoids surgery.
Cons: Can be uncomfortable, easily dislodged, potential for nasal irritation, increased risk of aspiration pneumonia, not ideal for long-term use.

Percutaneous Endoscopic Gastrostomy (PEG) Tube: A tube surgically inserted through the abdominal wall directly into the stomach. This procedure requires endoscopy and is typically reserved for individuals needing long-term nutritional support.

Making Informed Decisions About Tube Feeding

Choosing between NG and gastrostomy tube feeding for older adults with dysphagia requires careful consideration of individual patient factors, including age, overall health status, and the anticipated duration of nutritional support. While gastrostomy feeding may offer advantages in terms of complication-free survival and potentially improved nutrition outcomes, it's essential to weigh these benefits against the risks and burdens of a surgical procedure. Shared decision-making between clinicians, patients, and caregivers is crucial to ensure the best possible outcomes and quality of life.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1002/ncp.10195, Alternate LINK

Title: Long-Term Nasogastric Versus Percutaneous Endoscopic Gastrostomy Tube Feeding In Older Asians With Dysphagia: A Pragmatic Study

Subject: Nutrition and Dietetics

Journal: Nutrition in Clinical Practice

Publisher: Wiley

Authors: Mohamad Hasif Jaafar, Sanjiv Mahadeva, Kit Mun Tan, Ai-Vyrn Chin, Shahrul B. Kamaruzzaman, Hui Min Khor, Nor Izzati Saedon, Maw Pin Tan

Published: 2018-09-25

Everything You Need To Know

What is a nasogastric (NG) tube and when is it typically used?

A nasogastric (NG) tube is inserted through the nose, down the esophagus, and into the stomach. NG tubes are relatively easy to insert and don't require surgery, making them suitable for short-term feeding. However, they can be uncomfortable, easily dislodged, and may increase the risk of aspiration pneumonia, making them less ideal for long-term use.

How does a percutaneous endoscopic gastrostomy (PEG) tube differ from a nasogastric (NG) tube?

A percutaneous endoscopic gastrostomy (PEG) tube is surgically inserted through the abdominal wall directly into the stomach, requiring endoscopy. PEG tubes are typically reserved for individuals needing long-term nutritional support. While PEG tube placement is more invasive, it is associated with improved complication-free survival compared to NG tubes.

What are the key considerations when deciding between nasogastric (NG) and percutaneous endoscopic gastrostomy (PEG) tubes for elderly patients with dysphagia?

When choosing between nasogastric (NG) and percutaneous endoscopic gastrostomy (PEG) tubes for older adults with dysphagia, it's crucial to consider factors like age, overall health, and the anticipated duration of nutritional support. Shared decision-making involving clinicians, patients, and caregivers is essential to ensure the best possible outcomes and quality of life. Clinicians will weigh the ease of NG tube insertion against the long-term benefits and risks associated with PEG tubes.

What does this say about the complication rates associated with nasogastric (NG) versus percutaneous endoscopic gastrostomy (PEG) tubes?

While the text doesn't explicitly delve into specific complication rates, it does suggest that percutaneous endoscopic gastrostomy (PEG) tubes may offer advantages in complication-free survival. Nasogastric (NG) tubes, due to their placement and potential for dislodgement, carry a higher risk of aspiration pneumonia and nasal irritation. Further research and consultation with healthcare professionals are necessary to understand detailed complication rates associated with each type of tube.

What is dysphagia, and why is it relevant to the choice between nasogastric (NG) and percutaneous endoscopic gastrostomy (PEG) tubes?

Dysphagia is the medical term for difficulty swallowing. In the context, it refers to the swallowing difficulties experienced by older adults, which may necessitate tube feeding for adequate nutrition. The selection between nasogastric (NG) and percutaneous endoscopic gastrostomy (PEG) tubes aims to address this underlying condition while minimizing risks and optimizing nutritional outcomes. Without proper management, dysphagia can lead to malnutrition, dehydration, and increased risk of respiratory complications.