Al, I use a 20Fr and have never had a problem with it clogging up. Yes, a 30 is bigger. But I have never heard of anyone using one that large. The first PEG they put in usually has a long tube on it and that can be a nuisance. Once it needs to be replaced the next one can be a variety of choices. If you are truly concerned about someone pulling it out a Mic-Key might be a choice for you, but as I have said before, I tried one and did not like it as it was always getting clogged. I have never had an issue with my present PEG, it has a short tube that never seems to be in the way. Also, you are correct, the balloon is to hold it in. When it is time to change it the balloon is deflated and it is pulled out, a new one is inserted and the balloon is inflated. No pain or discomfort.