Effects of percutaneous endoscopic gastrostomy tube placement on gastric antral motility and gastric emptying

Ono, Hiromi; Azuma, Takeshi; Miyaji, Hideki; Ito, Shigeji; Ohtaki, Hideho; Ohtani, Masahiro; Dojo, Manabu; Yamazaki, Yukinao; Kuriyama, Masaru

doi:10.1007/s00535-003-1174-z

Cited by 20 publications

(20 citation statements)

References 29 publications

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“…17 Ono et al also reported that gastric motility is not related to GER after placement of the PEG tube. 34 The results that the GET of the semi-solid nutrients was not significantly different from that of the liquid nutrients in the present study indicated that the inhibition of nutrients in the later phase after infusion. The transition from the proximal to the distal stomach was improved in semi-solid nutrients.…”

Section: Discussionmentioning

confidence: 40%

Inhibition of Gastroesophageal Reflux by Semi‐solid Nutrients in Patients With Percutaneous Endoscopic Gastrostomy

Nishiwaki¹,

Araki

Shirakami

et al. 2009

J Parenter Enteral Nutr

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Section: Discussionmentioning

confidence: 40%

Inhibition of Gastroesophageal Reflux by Semi‐solid Nutrients in Patients With Percutaneous Endoscopic Gastrostomy

Nishiwaki¹,

Araki

Shirakami

et al. 2009

J Parenter Enteral Nutr

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“…They also reported that the presence of a cerebrovascular incident also indicated a higher risk for the development of pneumonia because it was generally associated with impairment of consciousness and difficulty with swallowing. Ono et al [10] reported that EHH might be a major risk for GER complications after PEG tube placement. RE and EHH can be detected by endoscopy with PEG.…”

Section: Discussionmentioning

confidence: 99%

“…The patients with scores ^ 2 appear to be at very low risk for aspiration pneumonia, and those with scores 6 3 should be carefully followed up. It should be considered that a semi-recumbent position [10] , jejunal tube feeding via the PEG tube [11] and conversion to half-solid nutrients [12] could prevent GER and aspiration pneumonia in patients with PEG.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Aspiration Pneumonia after Percutaneous Endoscopic Gastrostomy

Kitamura¹,

Nakase²,

Iizuka³

2007

Gerontology

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Background: Percutaneous endoscopic gastrostomy (PEG) is generally used for long-term enteral nutrition. Patients who require PEG placement are often very sick, and postoperative complications, especially aspiration pneumonia, can be fatal. Objective: In this study we investigated the risk factors for aspiration pneumonia after PEG using a simple two-step swallowing provocation test (S-SPT), as reported in 1999 by Teramoto et al. Methods: The study included 29 patients (10 men, 19 women; mean age 84.6 years) who underwent S-SPT before PEG. We evaluated the presence of reflux esophagitis (RE) and esophageal hiatal hernia (EHH) with PEG. According to the S-SPT results, a normal response to the 1st step S-SPT was given a score of 0, a normal response to the 2nd step S-SPT was given a score of 1, and an abnormal response to the 2nd step S-SPT was given a score of 3. In addition to S-SPT, the presence of RE was given a score of 3, the absence of RE was given a score of 0, the presence of EHH was given a score of 2, and the absence of EHH was given a score of 0. We evaluated the association between the presence of aspiration pneumonia, as an early and critical complication, up to 1 month after PEG and determined the total risk score (score of S-SPT+ score of RE+ score of EHH). Results: The group with an abnormal response to the 2nd step S-SPT and the group with RE both exhibited aspiration pneumonia. The patients with aspiration pneumonia all achieved total scores ≧3, and 8 of 13 patients without aspiration pneumonia achieved scores ≤2. Conclusions: S-SPT is particularly useful in PEG patients. The scores provided by S-SPT and endoscopic examination can be very useful for aspiration pneumonia after PEG. The patients with scores ≤2 appear to be at very low risk for aspiration pneumonia, and patients with the scores ≧3 should be carefully followed up.

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“…Myoelectrical activities of 2-4 cycles per min were defined as the normal range. Pre-and post-prandial myoelectrical activity showing over 70% of the normal range was defined as a normal EGG as described in our previous reports (11,12). The rate of gastric emptying was determined by measuring the plasma concentrations of paracetamol 45 minutes after oral intake of 1.5 g paracetamol with a 200 ml semi-liquid meal (OKUNOS-A, Horikawa Foods, Niigata, Japan) as described in our previous reports (11,12 …”

Section: Gastric Myoelectrical Activity and Gastric Emptyingmentioning

confidence: 99%

“…Gastric myoelectrical activity and gastric emptying have been widely applied to the evaluation of gastric motility in patients with various gastrointestinal disorders (9)(10)(11)(12). In the present study, we analyzed the accumulation of mitochondrial A3243G mutation in the stomach, gastric motility by myoelectrical activity and gastric emptying in patients with gastric symptoms, post-prandial nausea/vomiting and epigastralgia, and the mutation in their leukocytes.…”

Section: Introductionmentioning

confidence: 97%

Gastric Dysmotility Associated with Accumulation of Mitochondrial A3243G Mutation in the Stomach

et al. 2004

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Objective We analyzed the accumulation of a mitochondrial A-to-G mutation at nucleotide position 3243 (A3243G) in the stomach and gastric motility in patients with gastric symptoms, post-prandial nausea/vomiting and epigastralgia.Methods Detection and quantification of A3243G mutation in mtDNA in the gastric mucosa, oral mucosa, leukocyte, and skeletal muscle were performed. Gastric motility was evaluated by gastric myoelectrical activity on electrogastrography (EGG), and gastric emptying was evaluated by measurement of plasma paracetamol concentration before and after meals.Patients or Materials Four patients with A3243G mutation in the leukocyte mtDNA and gastric symptoms were examined.Results The A3243G mutation was detected at higher percentages in the gastric body (69-94% for mutation; mean, 83%) than in the angle portion (37-82%; mean, 52%), the antrum (40-84%; mean, 57%) or leukocytes (28-52%; mean, 39%), and at slightly higher percentages than in the skeletal muscles (45-87%; mean, 70%) or oral mucosae (52-86%; mean, 69%) in the four patients examined. Abnormal EGGs were observed in the three patients examined. The pre-prandial myoelectrical activities were low in these patients (49% in patient 1, 54% in patient 2, 63% in patient 3; normal >70%). The plasma concentrations of paracetamol were low (3.6 g/ml in patient 1, 2.4 g/ml in patient 2, <2.0 g/ml in patient 3; normal, 7-12 g/ml).Conclusion Accumulation of mitochondrial A3243G mutation in the stomach is a contributory factor in gastric dysmotility and gastric symptoms in patients with the mutation in their leukocytes.

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Effects of percutaneous endoscopic gastrostomy tube placement on gastric antral motility and gastric emptying

Cited by 20 publications

References 29 publications

Inhibition of Gastroesophageal Reflux by Semi‐solid Nutrients in Patients With Percutaneous Endoscopic Gastrostomy

Inhibition of Gastroesophageal Reflux by Semi‐solid Nutrients in Patients With Percutaneous Endoscopic Gastrostomy

Risk Factors for Aspiration Pneumonia after Percutaneous Endoscopic Gastrostomy

Gastric Dysmotility Associated with Accumulation of Mitochondrial A3243G Mutation in the Stomach

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