Percutaneous endoscopic gastrostomy and gastro-oesophageal reflux in neurologically impaired children

World J Gastroenterol. 2011 Jan 14;17(2):191-6. doi: 10.3748/wjg.v17.i2.191.


Aim: 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.

Conclusion: PEG placement increases GOR episodes in neurologically impaired children.

Keywords: Gastro-oesophageal reflux; Multiple intraluminal impedance; Percutaneous endoscopic gastrostomy.

MeSH terms

  • Adolescent
  • Cerebral Palsy / complications
  • Child
  • Child, Preschool
  • Down Syndrome / complications
  • Electric Impedance
  • Endoscopy / methods*
  • Female
  • Gastroesophageal Reflux / surgery*
  • Gastrostomy / methods*
  • Humans
  • Hydrogen-Ion Concentration
  • Infant
  • Male
  • Nervous System Diseases / complications*
  • Time Factors