title: Percutaneous Endoscopic Gastrostomy Prevents Gastroesophageal Reflux in Patients with Nasogastric Tube Feeding: A Prospective Study with 24-Hour pH Monitoring.
abstract: OBJECTIVE
  Percutaneous endoscopic gastrostomy (PEG) has been widely used for patients with swallowing dysfunction. However, its beneficial effects in the treatment of gastroesophageal reflux (GER) are controversial. The aim of this study was to evaluate the effect of PEG on the prevention of GER in patients with nasogastric tube (NGT) feeding.
  
  
  METHODS
  Continuous 24-hour pH monitoring was performed prospectively in 21 patients receiving NGT feeding before and 7.3±2.2 days after PEG placement to compare the severity of GER.
  
  
  RESULTS
  We studied 21 patients with a mean age of 59.8±14.1 years. The mean duration of NGT placement was 5.8±5.4 months. The causes of swallowing dysfunction included cerebral infarction, cerebral hemorrhage and other central nervous system (CNS) lesions. When all of the patients were considered, there were no significant differences in reflux parameters after PEG placement compared to before PEG placement. However, all seven patients who had preexisting GER showed significant improvement (p<0.05) of the reflux parameters, including the frequency of acid reflux, duration of acid reflux, total time with a pH below 4.0 and the fraction of time with a pH below 4.0, after PEG placement.
  
  
  CONCLUSIONS
  PEG might prevent GER in patients receiving NGT feeding, especially in those patients with GER.
authors.affiliation: Department of Internal Medicine, Cheil General Hospital, Kwandong University College of Medicine, Seoul, Korea.
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Jung
authors.forename: Seok Ho
authors.initials: SH
authors.lastname: Dong
authors.forename: Jae Yeon
authors.initials: JY
authors.lastname: Lee
authors.forename: Nam-Hoon
authors.initials: NH
authors.lastname: Kim
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Jang
authors.forename: Hyo Jong
authors.initials: HJ
authors.lastname: Kim
authors.forename: Byung-Ho
authors.initials: BH
authors.lastname: Kim
authors.forename: Young Woon
authors.initials: YW
authors.lastname: Chang
authors.forename: Rin
authors.initials: R
authors.lastname: Chang