The Changes in Esophageal Acidity during Percutaneous Endoscopic Gastrostomy Feeding

Lee, Jae Kyeong; Jang, Yoon Sik; Kim, Min Ki; Choi, Bong Ki; Park, Eun Taek; Lee, Yun Jae; Lee, Sang Hyuk; Seol, Sang Young; Jung, Jung Myung

Abstract

BACKGROUND/AIMS
Generally, we try on nasogastric tube (NGT) feeding in brain-injury patients with impaired swallowing. It has been known that percutaneous endoscopic gastrostomy (PEG) tube feeding is less complicated than NGT feeding. However, there is no accurate report for gastroesophageal reflux as complication following PEG and NGT. Therefore, we measured esophageal acidity before and after changing NGT feeding into PEG feeding in management of brain-injury patients, and then evaluated the degree of gastroesophageal reflux.
METHODS
Thirteen patients with impaired swallowing in brain-injury were included in this study. They all underwent NGT followed by PEG. Before and after PEG placement, 4 variables of acid exposure were evaluated with 24 hour ambulatory pH monitoring.
RESULTS
Number of acid reflux episodes decreased in 5 cases. Number of long acid reflux episodes decreased in 3 cases. Total and fraction time pH below 4.0 decreased in 6 cases. There was no significant difference in improvement of acid reflux between before and after PEG feeding (p>0.05).
CONCLUSIONS
Our data showed that acid reflux had a tendency to decrease in patients undergoing percutaneous endoscopic gastrostomy feeding, but it was increased in some of them.