Related Experiment Videos
Electrogastrography in gastrostomy-tube-fed children
J B Heikenen1, S L Werlin, C W Brown
1Division of Gastroenterology, Department of Pediatrics, The Medical College of Wisconsin, Milwaukee 53226, USA.
Insights
Children with gastrostomy tube feeding intolerance show abnormal postprandial power changes. Electrogastrography (EGG) may help identify underlying foregut motility issues in these patients.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Motility Disorders
- Medical Device Technology
Background:
- Gastrostomy tube feeding is common in children, but some experience intolerance with symptoms like gagging and vomiting.
- Conventional treatments for gastrostomy tube feeding intolerance are not always effective.
- Feeding intolerance may indicate an underlying foregut motility disorder.
Purpose of the Study:
- To investigate if children with gastrostomy tube feeding difficulties exhibit abnormal gastric electrical control activity.
- To assess the utility of electrogastrography (EGG) in identifying motility disorders in this population.
Main Methods:
- Cutaneous electrogastrography (EGG) was performed on 25 feeding-tolerant and 23 feeding-intolerant children under 10 years old.
- Measurements included dominant frequencies, rhythm indices, and postprandial power changes during fasting and feeding.
- Statistical analysis (Student's t test) compared differences between the tolerant and intolerant groups.
Main Results:
- No significant differences were found in EGG dominant frequencies or rhythm indices between groups.
- Feeding-intolerant children demonstrated a significantly lower mean postprandial power decrease compared to the tolerant group.
- Groups were comparable in gastrostomy tube placement, antireflux surgery, neurological impairment, and feeding characteristics.
Conclusions:
- Children intolerant to gastrostomy tube feedings exhibit abnormal postprandial power changes on EGG.
- EGG dominant frequency and rhythm indices are not reliable predictors of feeding tolerance, especially in neurologically impaired children.
- Abnormal postprandial power decrease suggests a potential role for EGG in evaluating foregut motility in gastrostomy tube feeding intolerance.
Abstract:
Following gastrostomy tube placement some children develop gagging, retching, vomiting, pain, or irritability during feedings. Conventional medical management is not always successful. It is possible that intolerance of gastrostomy tube feedings reflects an underlying motility disorder of the foregut. The study aim was to determine whether children with gastrostomy tube feeding difficulties demonstrate abnormal gastric electrical control activity as measured by electrogastrography. Cutaneous electrogastrography of interpretable quality was performed in 25 feeding-tolerant and 23 feeding-intolerant children less than 10 years of age. Dominant frequencies, rhythm indices, and postprandial power measurements were recorded during the fasting and postprandial periods. Differences between groups were compared using the Student's t test. The groups were similar in method of gastrostomy tube placement, antireflux surgery, neurological impairment, duration of gastrostomy feeding dependence, formula type, volume, and administration. The feeding-tolerant group was significantly older (P<0.01). There were no significant differences between groups in the mean dominant frequencies or rhythm indices. The feeding-intolerant children had a mean postprandial power change that was significantly lower than that of the feeding tolerant group (P<0.003), although overlap was present. Children who are intolerant of gastrostomy tube feeding have an abnormal postprandial power decrease. EGG dominant frequency and rhythm indices are not predictive of gastrostomy feeding tolerance in predominantly neurologically impaired children.