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Transition from PEG Feedings to Oral Feedings for Patients with Head and Neck Cancer

This information explains the transition from PEG feedings to oral feedings for patients with head and neck cancer.

You may now begin to eat, or eat more, by mouth. It will gradually become easier to swallow. You should slowly change from using your feeding tube (PEG) to eating and drinking by mouth again. The suggestions below will help you make this transition. Remember this may take some time, so start slowly.

  • Do not stop your PEG tube feedings all at once.
  • Slowly decrease your daily tube feedings until you are taking in all your calories by mouth.
    • Check to see how many calories each can of supplement gives you.
    • Reduce one can at a time while you take more calories by mouth. If you normally take 8 cans in your PEG tube each day, reduce to 7 cans.
    • If you have trouble eating more, wait a few days before trying to reduce the cans.
    • Make up the difference in calories by drinking or eating this amount.
    • Call your dietitian if you have questions about what foods to eat and how to count calories.
  • If you begin to cough when you swallow, food or liquid may be getting into your airway. This is called aspiration. Call your doctor or nurse and the swallowing specialist right away. Your swallowing specialist will guide you on which foods and liquids are safe for you to try.

Aspiration can lead to pneumonia. Signs of pneumonia include:

  • Shortness of breath
  • Wheezing
  • Painful breathing
  • A productive cough

You may or may not have a fever. A fever is a temperature of 100.4° F (38° C) or higher. Call your doctor or nurse immediately if you have any of these symptoms.

  • Check your weight at least 2 times a week to be sure you are not losing weight.
  • Try different textures of foods to see which are easiest for you to swallow. If a certain food is hard to swallow or does not taste good, then try it again the next week. Try again and again. As you heal, your sense of taste will improve and it will be easier to swallow.
  • Liquids and puréed foods may be the easiest to swallow at first. Examples include:
    • Homemade milkshakes
    • Nutritional supplements such as Ensure®, Boost®, Carnation® Instant Breakfast, and Glucerna® (if you are diabetic)
    • Puddings
    • Soups
    • Plain or well-blended yogurt without fruit pieces
    • Cream of wheat
    • Puréed egg salad
    • Puréed cooked vegetables
    • Puréed fruits
    • Strained or puréed meat, fish, and poultry
  • When you can swallow liquids and puréed foods easily, try the foods below. They require less chewing than foods on a regular diet. Examples include:
    • Cottage cheese
    • Well-cooked diced vegetables
    • Canned or cooked fruits without the skin
    • Pancakes
    • Diced soft pastas
    • Ground, finely chopped tender meat
    • Ground, finely chopped poultry with gravy
    • Diced meat loaf
    • Diced baked or broiled fish
    • Quiches or souffles
    • Scrambled eggs
  • Refer to the Eating Guide for Mechanical Soft and Puréed Diets booklet for other food selections.
  • Once you are able to eat soft foods easily, try going back to your regular menu.
  • Once you maintain your weight without using your feeding tube for 2 to 4 weeks, your feeding tube can be removed. Maintain your weight by taking liquids, puréed foods, or mechanical soft foods. You do not have to be back on your regular diet to have the tube removed.

Eating well is as important after cancer treatment as it was during treatment. It will help you stay well hydrated, and maintain your weight and energy level.

  • If you are having problems swallowing, call your swallowing specialist.

Phone number _________________

  • If you want more information about foods that are easy to swallow, call your dietitian.

Phone number _________________

  • If you are having pain that is preventing you from swallowing, call your doctor or nurse.

Phone number _________________

  • Once your feeding tube is ready to be removed, make an appointment with your gastroenterologist.

Phone number _________________