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Percutaneous endoscopic gastrostomy placement in paediatric Crohn's disease patients contributes to both improved
H Duncan1, A Painesi2, E Buchanan1
1Department of Nutrition & Dietetics, The Royal Hospital for Children, Glasgow, UK.
Insights
Gastrostomy feeding improved nutrition and growth in pediatric Crohn's disease (CD) patients. This intervention led to significant weight gain and enhanced anthropometric measurements over two years.
Area of Science:
- Pediatric Gastroenterology
- Clinical Nutrition
- Inflammatory Bowel Disease
Background:
- Crohn's disease (CD) in children can lead to malnutrition and growth failure.
- Nutritional support is crucial for managing pediatric CD.
- Gastrostomy feeding offers a method for intensive nutritional intervention.
Purpose of the Study:
- To evaluate the outcomes of gastrostomy feeding in pediatric patients with Crohn's disease.
- To assess the impact of gastrostomy feeding on nutritional status, growth, and clinical outcomes.
Main Methods:
- Retrospective review of 16 pediatric CD patients who received gastrostomy feeding for at least two years.
- Data collected included anthropometrics, CD phenotype, surgical technique, complications, and feeding details.
- Analysis of changes in body mass index (BMI) z-score, weight z-score, and height z-score pre- and post-feeding.
Main Results:
- Gastrostomy insertion via pull technique was most common; 56% experienced short-term complications.
- Significant improvements in BMI z-score (1.11 at 12 months) and weight z-score (0.19 at 12 months) were observed.
- Height z-score improved (-1.03 at 24 months), and daily feed volume and calories significantly increased post-insertion.
Conclusions:
- Gastrostomy feeding is an effective intervention for improving nutritional status in pediatric Crohn's disease.
- The procedure is associated with significant weight gain and improved growth parameters.
- Gastrostomy feeding positively impacts key anthropometric measures in children with CD.
Aim:
This paper describes the outcomes of gastrostomy feeding in patients with Crohn's disease (CD).
Methods:
Patients with CD who attended the Royal Hospital for Children, Glasgow and received gastrostomy feeding for at least two years between 2003 and 2010 were identified from the clinical database. The data recorded included the anthropometric data, CD phenotype, the surgical technique that was used, complications, medication, feed type, median feed, calories, volume and clinical outcomes.
Results:
The study identified 16 patients (14 male) who had a gastrostomy inserted using a pull technique at a median age of 12.6 years. Of these two required laparoscopic placement. Short-term complications lasting less than one month were experienced by nine (56%) patients and one (6%) experienced long-term complications. Anthropometry significantly improved at follow-up compared to baseline: at 12 months, the body mass index z-score was 1.11 (p = 0.005) and the weight z-score was 0.19 (p < 0.05). At 24 months, the height z-score was -1.03 (p = 0.04). The daily median volume and calories from feeds increased significantly from baseline to post-PEG insertion, from 400 to 738 mL and 705 to 860 kcal/day (p ≤ 0.01).
Conclusion:
Gastrostomy feeding for paediatric patients with CD was associated with improved nutrition, weight gain and growth outcomes.
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