Can I continue to eat after having a PEG tube inserted?

Having a PEG tube and maintaining a regular diet (oral food intake) are not mutually exclusive. On the contrary: The majority of people with ALS who have a PEG tube continue to consume fluids and food—as long as their ALS-related swallowing disorder allows it. Combining regular food intake with PEG tube feeding is possible and common practice.

As ALS progresses, there are usually changes in the ratio of oral intake to PEG feeding. At the start of PEG feeding (especially when the PEG tube is placed early), use of the PEG tube may be limited to the administration of fluids and small amounts of tube feed. As dysphagia worsens, the proportion of oral intake decreases and the use of the PEG tube for caloric intake increases. In cases of severe dysphagia, the balance may shift further in favor of the PEG tube: In this situation, caloric needs are met predominantly or entirely through the PEG tube, while only small amounts of oral food are consumed, primarily for the enjoyment of the (smaller) meal.

The ability to combine oral intake with PEG feeding is one of the key reasons not to delay the placement of a PEG tube when it is medically necessary. The PEG tube itself does not result in a “withdrawal” from a regular diet or oral intake. The limitation on oral intake results from ALS-related dysphagia and not from the PEG tube placement procedure itself. Combined nutrition via both oral intake and the PEG tube should be coordinated with a nutrition team and “balanced.” A nutritional balance sheet documents the proportion of calories consumed via tube feeding versus oral intake. By combining both forms of nutrition, it is essential to ensure a positive energy balance and adequate caloric intake.