The feeding tube is usually inserted by percutaneous endoscopic gastrostomy (PEG). Minor leakage may cause irritation of the skin around the gastrostomy site or stoma. There is no good evidence about the effectiveness or safety of gastrostomy. Treatment of buried bumper syndrome consists of removal of the gastrostomy tube. Infants and patients fed via a gastrostomy tube can also be given a ketogenic diet. The opening may be used for feeding, such as with a gastrostomy tube. One type is the percutaneous endoscopic gastrostomy (PEG) tube which is placed endoscopically. This method requires a nasogastric or gastrostomy tube and pump. Administration methods directly into the stomach include those by gastric feeding tube or gastrostomy. Feeding difficulties can be managed with specialized assistive devices or with a gastrostomy (feeding) tube. Gastrostomy, or G-tube, allows for tube feedings into the stomach through the abdominal wall. Gastrostomy tubes are used to circumvent feeding difficulties and prevent aspiration. A lower incidence and severity of dysphagia also means that less patients require gastrostomy feeding. If feeding becomes difficult, a gastrostomy tube may be considered. Gastrostomy to deliver food directly into the stomach is possible in severe cases.