What is a key prevention method for Buried Bumper Syndrome?

• A. Rotate daily and move PEG in and out 1-2 cm
• B. Remove PEG permanently
• C. Increase feeding frequency
• D. Use larger balloon

Answer: (A)

Buried bumper syndrome happens when the internal bumper presses too hard on the gastric wall, leading to tissue ischemia and the bumper becoming embedded. The most effective prevention is to relieve that constant pressure and keep the tract mobile. By rotating the external bolster daily and gently moving the tube in and out a small amount (about 1–2 cm), you reduce focal pressure, prevent tissue overgrowth around the bumper, and maintain a wide, healthy tract. This directly addresses the mechanism that causes burying, making it the best preventive step. Removing the PEG would cut off access unnecessarily; increasing feeding frequency doesn’t affect bumper pressure; using a larger balloon could worsen pressure and risk.