Electrogastrography in gastrostomy-tube-fed children.
Following gastrostomy tube placement some children develop gagging, retching, vomiting, pain, or irritability during feedings. Conventional medical management is not always successful. It is possible that intolerance of gastrostomy tube feedings reflects an underlying motility disorder of the foregut. The study aim was to determine whether children with gastrostomy tube feeding difficulties demonstrate abnormal gastric electrical control activity as measured by electrogastrography. Cutaneous electrogastrography of interpretable quality was performed in 25 feeding-tolerant and 23 feeding-intolerant children less than 10 years of age. Dominant frequencies, rhythm indices, and postprandial power measurements were recorded during the fasting and postprandial periods. Differences between groups were compared using the Student's t test. The groups were similar in method of gastrostomy tube placement, antireflux surgery, neurological impairment, duration of gastrostomy feeding dependence, formula type, volume, and administration. The feeding-tolerant group was significantly older (P<0.01). There were no significant differences between groups in the mean dominant frequencies or rhythm indices. The feeding-intolerant children had a mean postprandial power change that was significantly lower than that of the feeding tolerant group (P<0.003), although overlap was present. Children who are intolerant of gastrostomy tube feeding have an abnormal postprandial power decrease. EGG dominant frequency and rhythm indices are not predictive of gastrostomy feeding tolerance in predominantly neurologically impaired children.
Heikenen
J B
JB
Division of Gastroenterology, Department of Pediatrics, The Medical College of Wisconsin, Milwaukee 53226, USA.
Werlin
S L
SL
Brown
C W
CW
D002648:Child; D002675:Child, Preschool; D004568:Electrodiagnosis; D004750:Enteral Nutrition; D005260:Female; D005746:Gastric Emptying / Q000502:physiology*; D005774:Gastrostomy; D006801:Humans; D007223:Infant; D008297:Male; D009130:Muscle, Smooth / Q000503:physiopathology; D011183:Postoperative Complications / Q000503:physiopathology*; D019518:Postprandial Period / Q000502:physiology; D012815:Signal Processing, Computer-Assisted; D014839:Vomiting / Q000503:physiopathology*