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Inhibition of Gastroesophageal Reflux by Semi‐solid Nutrients in Patients With Percutaneous Endoscopic Gastrostomy
Author(s) -
Nishiwaki Shinji,
Araki Hiroshi,
Shirakami Yohei,
Kawaguchi Junji,
Kawade Naofumi,
Iwashita Masahide,
Tagami Atsushi,
Hatakeyama Hiroo,
Hayashi Takao,
Maeda Teruo,
Saitoh Koushirou
Publication year - 2009
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607108327045
Subject(s) - nutrient , reflux , medicine , percutaneous endoscopic gastrostomy , gastric emptying , stomach , gastroenterology , nutrient agar , peg ratio , chemistry , agar , biology , bacteria , disease , organic chemistry , finance , economics , genetics
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.