Document Detail


Gastroesophageal reflux during gastrostomy feeding.
MedLine Citation:
PMID:  8276174     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: Aspiration pneumonia is one of the most serious complications of gastrostomy tube feeding, with a reported incidence of 10%-20% in nursing home patients. The aims of this prospective study were to examine lower esophageal sphincter (LES) pressure before and after placement of gastrostomy tubes and to examine the effects of rapid intragastric bolus and slow, continuous feeding on LES pressure. METHODS: Ten subjects were enrolled in the study. Basal LES pressure was measured before and after placement of gastrostomy tubes. Thereafter, LES pressure was measured for 15 minutes during rapid intragastric infusion of 250 mL of an enteral feeding formula and 100 mL water and continuous infusion of the enteral feeding formula at 80 mL/h. Scintigrams evaluating gastroesophageal reflux were obtained during each method of feeding. RESULTS: Placement of gastrostomy tubes had no effect on basal LES pressure. Rapid intragastric bolus infusion led to a reduction in LES pressure to incompetent levels at 2.1 +/- 2.0 mm Hg (P < 0.001). Free gastroesophageal reflux to the sternal notch was shown by scintigraphy. Slow, continuous gastrostomy feedings did not alter LES pressure (P > 0.05) or show free gastroesophageal reflux by scintigraphy. CONCLUSIONS: Gastroesophageal reflux and aspiration in patients fed via the gastrostomy tube may be caused by LES relaxation secondary to gastric distention caused by distention of the stomach.
Authors:
R M Coben; A Weintraub; A J DiMarino; S Cohen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Gastroenterology     Volume:  106     ISSN:  0016-5085     ISO Abbreviation:  Gastroenterology     Publication Date:  1994 Jan 
Date Detail:
Created Date:  1994-02-07     Completed Date:  1994-02-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  13-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Presbyterian Medical Center, University of Pennsylvania, Philadelphia.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Enteral Nutrition / adverse effects*,  methods
Esophagogastric Junction / physiopathology
Female
Gastroesophageal Reflux / etiology*,  radionuclide imaging
Gastrostomy*
Humans
Male
Manometry
Pressure
Prospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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