title: Clinical analysis of gastroesophageal reflux after PEG.
abstract: BACKGROUND
  It is difficult to predict whether or not gastroesophageal reflux (GER), such as aspiration or vomiting, will occur after PEG.
  
  
  OBJECTIVE
  To identify factors that would support the prediction of aspiration after PEG.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  Patients who underwent PEG from February 1998 to June 2005 in our hospital.
  
  
  METHODS
  The study included 178 patients.
  
  
  METHODS
  Endoscopic observation was carried out during PEG tube placement and at PEG tube replacement to determine the presence of hiatus hernia and/or reflux esophagitis.
  
  
  METHODS
  Gastric emptying and GER index (GERI) were measured by using a radioisotope technique.
  
  
  RESULTS
  The patients were divided into 2 groups: the non-GER (NGER) group (n = 108), who had no symptoms of GER, and the GER group (n = 70), who showed these symptoms. No significant differences were observed between the groups in age, sex, morbidity, the presence of reflux esophagitis at PEG tube placement, gastric emptying, or serum albumin levels. The presence of a hiatus hernia (P = .028) and reflux esophagitis grading Los Angeles classification C or D (P = .008) were significantly more frequent in the GER group compared with the NGER group. The GERI was also significantly higher in the GER group than in the NGER group (P < .0001).
  
  
  CONCLUSIONS
  The presence of hiatus hernia, severe reflux esophagitis, and a high GERI might be predictive factors of aspiration or vomiting after PEG tube placement.
authors.affiliation: Department of Internal Medicine, Nishimino Kousei Hospital, Gifu, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Nishiwaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Araki
authors.forename: Naoe
authors.initials: N
authors.lastname: Goto
authors.forename: Yukari
authors.initials: Y
authors.lastname: Niwa
authors.forename: Masaya
authors.initials: M
authors.lastname: Kubota
authors.forename: Masahide
authors.initials: M
authors.lastname: Iwashita
authors.forename: Nobuhito
authors.initials: N
authors.lastname: Onogi
authors.forename: Hiroo
authors.initials: H
authors.lastname: Hatakeyama
authors.forename: Takao
authors.initials: T
authors.lastname: Hayashi
authors.forename: Teruo
authors.initials: T
authors.lastname: Maeda
authors.forename: Koushirou
authors.initials: K
authors.lastname: Saitoh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004932:Esophageal and Gastric Varices / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D005746:Gastric Emptying; D005774:Gastrostomy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index