Influence of replacing percutaneous endoscopic gastrostomy for nasogastric tube feeding on gastroesophageal reflux disease with erosive esophagitis

Abstract

Background: The occurrence rate and severity of gastroesophageal reflux disease with erosive esophagitis (EE) in patients after converting nasogastric tube (NGT) feeding to percutaneous endoscopic gastrostomy (PEG) are not well-known. The aim of this study was to determine the influence of PEG placement on the occurrence and severity of EE in patients with long-term PEG feeding. Methods: This retrospective study included patients with NGT feeding who were converted to PEG feeding and received pre-and post-PEG endoscopy between January 2000 and June 2013. Factors predictive of the occurrence of EE after PEG were analyzed. Results: One-hundred and twenty patients with NGT feeding were converted to PEG, and 47 patients were included. Before PEG, 21 (44.7%) NGT-feeding patients had EE. The mean follow-up time was 45.7 months (range, 6e147 months). Erosive esophagitis occurred in nine (19.1%) patients after PEG. The occurrence rate (p < 0.01) and severity (p < 0.05) of EE significantly improved after PEG, compared to before PEG. Hill's classification of gastroesophageal valve was associated with the occurrence of EE after PEG (p < 0.01).Advances in Digestive Medicine (2016) 3, 49e55Conclusion: The occurrence and severity of esophagitis improved after converting the patient to PEG. Hill's grading of gastroesophageal valve provides useful information for predicting the occurrence of EE after PEG.