Percutaneous endoscopic gastrostomy (PEG) does not worsen vomiting in children

Kakade, Madhavi; Coyle, David; McDowell, Dermot T.; Gillick, John

doi:10.1007/s00383-015-3707-y

Cited by 10 publications

(3 citation statements)

References 22 publications

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“…However, bodily discomfort still constituted a part of Lisa’s daily life and thus had a great impact on her overall health and well-being. On the other hand, a G-tube does not seem to worsen vomiting or other gastro-oesophageal reflux (GER) associated symptoms (Kakade et al, 2015 ). Nevertheless, research has shown that those who receive food soon after a G-tube insertion suffer from nausea and vomiting to a higher degree compared to those who receive delayed tube feeding (Peck et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Experiences before and after nasogastric and gastrostomy tube insertion with emphasis on mealtimes: a case study of an adolescent with cerebral palsy

Mårtensson

Cederlund

Nolbris

et al. 2021

International Journal of Qualitative Studies on Health and Well

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Purpose : Adolescents with cerebral palsy may need a feeding tube due to feeding challenges, since nutritional intake and mealtimes may be negatively affected. The purpose of the study was to describe and better understand how one adolescent with cerebral palsy and her parents experienced mealtimes before and after a nasogastric and gastrostomy tube insertion and how the use of these feeding tubes was experienced in daily life. Methods : Individual interviews were performed with one adolescent and each of her parents. In total, six interviews were conducted on two separate occasions. The qualitative approach known as Interpretive Description was used during the analysis. Results : Four thematic patterns were identified within the data: (i) struggling with nutritional intake, (ii) the paradox of using an aid, (iii) being different, and (iv) challenges of public mealtimes. Conclusions : The results showed that four themes influenced daily mealtimes in adolescents with cerebral palsy and a gastrostomy tube. Nutritional intake and mealtimes may be difficult, which is why using a gastrostomy tube can be a relief. However, the gastrostomy tube can also pose a challenge and a paradox. Time of change and acceptance seems necessary in order to meet these challenges.

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Section: Discussionmentioning

confidence: 99%

Experiences before and after nasogastric and gastrostomy tube insertion with emphasis on mealtimes: a case study of an adolescent with cerebral palsy

Mårtensson

Cederlund

Nolbris

et al. 2021

International Journal of Qualitative Studies on Health and Well

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“…In the present review of studies involving children, similarly, there was little to no difference in vomiting events between the early feeding and delayed feeding groups. The mechanism of gastroesophageal reflux disease, which causes vomiting after PEG placement is partly associated with changes in the angle of His or increased gastric distension with perturbation of the lower esophageal sphincter, and this is seen in children [30,31]; however, vomiting events can improve on their own or be treated with medical therapy in most children [32,33]. This may explain the less significant effects of feeding on these events in children.…”

Section: Discussionmentioning

confidence: 99%

Early versus Delayed Feeding after Percutaneous Endoscopic Gastrostomy Placement in Children: A Meta-Analysis

Watanabe

Kotani

2020

Children

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Early feeding after percutaneous endoscopic gastrostomy (PEG) placement is an accepted practice in the treatment of adult patients and the knowledge is clinically extrapolated in the treatment of children. To verify this treatment in children—as there are some specific features of PEG-related practices in children—the present study aimed to review meta-analyses of early feeding (within 4 h) after PEG placement in children. We searched the PubMed database for articles published until July 2020. A quality assessment was performed using the Grading of Recommendations, Assessment, Development, and Evaluation method. Three randomized controlled trials (208 patients) were eligible for inclusion. No patients died within 72 h. Early feeding resulted in little to no difference in the length of hospital stay (mean difference [MD] −7.47, 95% confidence interval [CI] −25.16 to 10.21; I2 = 95%) and vomiting events (risk ratio 0.84, 95% CI 0.55 to 1.31; I2 = 0%). In a subgroup analysis, early feeding without antibiotics reduced the length of hospital stay in one study (MD −21.60, 95% CI −22.86 to −20.34) but early feeding with antibiotics did not affect the length in two studies (MD 0.28, 95% CI −6.49 to 7.06; I2 = 0%). Overall, the certainty of the evidence was not very high. In summary, early feeding after PEG placement may be a safe alternative to delayed feeding in children. The findings in children seemed similar to those in adults, while there is a need for further studies that specifically investigate PEG placement-related practices in children.

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“…A radiographic study can outline anatomy prior to the procedure, and may be requested by the individual placing the enteral feeding tube. There is no evidence that GT placement induces gastroesophageal reflux disease (GERD) [43][44][45]. In the non-CF population, approximately 10% of children required an anti-reflux procedure after GT placement [46,47]; clinical assessment was sufficient to determine if a child would do well with GT alone, compared to GT combined with an anti-reflux procedure [48].…”

Section: The Cf Foundation Recommends Evaluation By a Multidisci-mentioning

confidence: 99%

Enteral tube feeding for individuals with cystic fibrosis: Cystic Fibrosis Foundation evidence-informed guidelines

Schwarzenberg

Hempstead

McDonald

et al. 2016

Journal of Cystic Fibrosis

107

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Nutrition is integral to the care of individuals with cystic fibrosis (CF). Better nutritional status is associated with improved pulmonary function. In some individuals with CF, enteral tube feeding can be useful in achieving optimal nutritional status. Current nutrition guidelines do not include detailed recommendations for enteral tube feeding. The Cystic Fibrosis Foundation convened an expert panel to develop enteral tube feeding recommendations based on a systematic review of the evidence and expert opinion. These guidelines address when to consider enteral tube feeding, assessment of confounding causes of poor nutrition in CF, preparation of the patient for placement of the enteral feeding tube, management of the tube after placement and education about enteral feeding. These recommendations are intended to guide the CF care team, individuals with CF, and their families through the enteral tube feeding process.

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Percutaneous endoscopic gastrostomy (PEG) does not worsen vomiting in children

Abstract: PEG insertion does not appear to induce symptomatic gastro-oesophageal reflux in the majority of children, suggesting that in the majority of cases, a concurrent anti-reflux procedure is unnecessary. Parents should be counseled accordingly.

Cited by 10 publications

References 22 publications

Experiences before and after nasogastric and gastrostomy tube insertion with emphasis on mealtimes: a case study of an adolescent with cerebral palsy

Experiences before and after nasogastric and gastrostomy tube insertion with emphasis on mealtimes: a case study of an adolescent with cerebral palsy

Early versus Delayed Feeding after Percutaneous Endoscopic Gastrostomy Placement in Children: A Meta-Analysis

Enteral tube feeding for individuals with cystic fibrosis: Cystic Fibrosis Foundation evidence-informed guidelines

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