Inhibition of gastroesophageal reflux by semi-solid nutrients in patients with percutaneous endoscopic gastrostomy.
BACKGROUND
Aspiration is one of the major complications after percutaneous endoscopic gastrostomy (PEG). The administration of semi-solid nutrients by means of gastrostomy tube has recently been reported to be effective in preventing aspiration pneumonia. The effects of semi-solid nutrients on gastroesophageal reflux, intragastric distribution, and gastric emptying were evaluated.


METHODS
Semi-solid nutrients were prepared by liquid nutrients mixed with agar at the concentration of 0.5%. The distribution of the administered radiolabeled liquid and semi-solid nutrients was monitored by a scintillation camera for 15 post-PEG patients. The percentage of esophageal reflux, the distribution of the proximal and distal stomach, and the gastric emptying time were evaluated.


RESULTS
The percentage of gastroesophageal reflux was significantly decreased in semi-solid nutrients (0.82 +/- 1.27%) compared with liquid nutrients (3.75 +/- 4.25%), whereas the gastric emptying time was not different. The distribution of semi-solid nutrients was not different from liquid nutrients in the early phase, whereas higher retention of liquid nutrients in the proximal stomach was observed in the late phase.


CONCLUSIONS
Gastroesophageal reflux was significantly inhibited by semi-solid nutrients. One of the mechanisms of the inhibition is considered to be an improvement in the transition from the proximal to distal stomach in semi-solid nutrients.
Nishiwaki
Shinji
S
Department of Internal Medicine, Nishimino Kosei Hospital, and Department of Gastroenterology, Graduate School of Medicine, Gifu University, Oshikoshi 986, Yoro-cho, Yoro-gun, Gifu 503-1394, Japan. wakky@nishimino.gfkosei.or.jp
Araki
Hiroshi
H
Shirakami
Yohei
Y
Kawaguchi
Junji
J
Kawade
Naofumi
N
Iwashita
Masahide
M
Tagami
Atsushi
A
Hatakeyama
Hiroo
H
Hayashi
Takao
T
Maeda
Teruo
T
Saitoh
Koushirou
K
D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects* / Q000379:methods; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D005746:Gastric Emptying; D005764:Gastroesophageal Reflux / Q000150:complications / Q000517:prevention & control*; D005774:Gastrostomy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D011015:Pneumonia, Aspiration / Q000209:etiology / Q000517:prevention & control; D019275:Radiopharmaceuticals; D017556:Technetium Compounds; D017971:Tin Compounds; D014783:Viscosity
D019275:Radiopharmaceuticals; D017556:Technetium Compounds; D017971:Tin Compounds; C033493:technetium Tc 99m tin colloid