Percutaneous endoscopic gastrostomy and gastro-oesophageal reflux in neurologically impaired children.
OBJECTIVE
To investigate the effects of percutaneous endoscopic gastrostomy (PEG) feeding on gastro-oesophageal reflux (GOR) in a group of these children using combined intraluminal pH and multiple intraluminal impedance (pH/MII).


METHODS
Ten neurologically impaired children underwent 12 h combined pH/MII procedures at least 1 d before and at least 12 d after PEG placement.


METHODS
Prior to PEG placement (pre-PEG) a total of 183 GOR episodes were detected, 156 (85.2%) were non-acidic. After PEG placement (post-PEG) a total of 355 episodes were detected, 182 (51.3%) were non-acidic. The total number of distal acid reflux events statistically significantly increased post-PEG placement (pre-PEG total 27, post-PEG total 173, P = 0.028) and the mean distal pH decreased by 1.1 units. The distal reflux index therefore also significantly increased post-PEG [pre-PEG 0.25 (0-2), post-PEG 2.95 (0-40)]. Average proximal pH was lower post-PEG but the within subject difference was not statistically significant (P = 0.058). Median number of non-acid GOR, average reflux height, total acid clearance time and total bolus clearance time were all lower pre-PEG, but not statistically significant.


CONCLUSIONS
PEG placement increases GOR episodes in neurologically impaired children.
Centre for Paediatric Gastroenterology, Royal Free and University College Medical School, Pond Street, London NW32QG, United Kingdom. mike.thomson@sch.nhs.uk
Mike
M
Thomson
Prithviraj
P
Rao
David
D
Rawat
Tobias G
TG
Wenzl
D000293:Adolescent; D002547:Cerebral Palsy / Q000150:complications; D002648:Child; D002675:Child, Preschool; D004314:Down Syndrome / Q000150:complications; D017097:Electric Impedance; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005764:Gastroesophageal Reflux / Q000601:surgery*; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007223:Infant; D008297:Male; D009422:Nervous System Diseases / Q000150:complications*; D013997:Time Factors
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