Inhibition of gastroesophageal reflux by semi-solid nutrients in patients with percutaneous endoscopic gastrostomy

JPEN J Parenter Enteral Nutr. Sep-Oct 2009;33(5):513-9. doi: 10.1177/0148607108327045. Epub 2009 Jun 1.

Abstract

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.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Endoscopy, Gastrointestinal / adverse effects*
  • Endoscopy, Gastrointestinal / methods
  • Enteral Nutrition / methods*
  • Female
  • Gastric Emptying
  • Gastroesophageal Reflux / complications
  • Gastroesophageal Reflux / prevention & control*
  • Gastrostomy / adverse effects*
  • Gastrostomy / methods
  • Humans
  • Male
  • Pneumonia, Aspiration / etiology
  • Pneumonia, Aspiration / prevention & control
  • Radiopharmaceuticals
  • Technetium Compounds
  • Tin Compounds
  • Viscosity

Substances

  • Radiopharmaceuticals
  • Technetium Compounds
  • Tin Compounds
  • technetium Tc 99m tin colloid