Usefulness of semi-solid medical foods administered after percutaneous endoscopic gastrostomy

(1) Department of Gastroenterology, Fuyoukai Murakami Hospital, Japan

Abstract
Background: Even if preoperative enteral nutrition is administered without any issues, some patients suffer from gastrointestinal symptoms (e.g., vomiting and diarrhea) after initiating gastrostomy feeding. Because of the amino acid composition and limited amount of lipids, elemental diets may reduce the risk of gastrointestinal symptoms. However, elemental diets are expensive. Semi-solid medical foods are inexpensive and more closely mimic normal physiology than elemental diets. The aim of the present study was to investigate the usefulness of semi-solid medical foods when administered after percutaneous endoscopic gastrostomy (PEG).
Method: This retrospective study analyzed 91 patients who had PEG performed by the author who was the attending physician. All patients received preoperative enteral nutrition with liquid nutrients, and there were no instances of gastrointestinal symptoms before PEG tube placement. The types of nutrients administered after PEG were divided into three categories: semi-solid medical foods (n = 20), polymeric formulas (n = 26), and elemental diets (n = 45). The incidence of gastrointestinal symptoms was compared among the three groups.
Results: No gastrointestinal symptoms occurred in the semi-solid medical foods group; the incidence of gastrointestinal symptoms in the semi-solid medical foods group was significantly lower than that of the polymeric formulas group [0% vs. 26.9% (7/26), p < 0.05] and was similar to that of the elemental diets group [0% vs. 2.2% (1/45), p = 1].
Conclusion: If preoperative enteral nutrition is administered without any issues, semi-solid medical foods are useful as nutrients administered after PEG tube placement.
Keywords
References
Boullata JI, Carrera AL, Harvey L, Escuro AA, Hudson L, Mays A, et al. ASPEN safe practices for enteral nutrition therapy. JPEN J Parenter Enteral Nutr 2017;41:15-103.
Sasaki M. Guideline for enteral nutrition. Journal of JSPEN 2013;28:1201-8. (in Japanese).
Kajihara Y. Risk factors for gastrointestinal symptoms post enteral nutrition initiation via a gastrostomy tube. The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy 2020;21:207-11.
Horiuchi A, Nakayama Y, Sakai R, Suzuki M, Kajiyama M, Tanaka N. Elemental diets may reduce the risk of aspiration pneumonia in bedridden gastrostomy-fed patients. Am J Gastroenterol 2013;108:804-10.
Pearce CB, Duncan HD. Enteral feeding. Nasogastric, nasojejunal, percutaneous endoscopic gastrostomy, or jejunostomy: its indications and limitations. Postgrad Med J 2002;78:198-204.
Kanda Y. Investigation of the freely available easy-to-use software “EZR” for medical statistics. Bone Marrow Transplant 2013;48:452-8.
Toh Yoon EW, Yoneda K, Nishihara K. Semi-solid feeds may reduce the risk of aspiration pneumonia and shorten postoperative length of stay after percutaneous endoscopic gastrostomy (PEG). Endosc Int Open 2016;4: E1247-51.
Muramatsu H, Okamoto T, Kubo T, Matsuki M, Iwata S, Fujiwara A, et al. Differences in the incidence of postoperative pneumonia after percutaneous endoscopic gastrostomy between liquid and semi-solid nutrient administration. Eur J Clin Nutr 2019;73:250-7.
Muramatsu H, Tanaka I, Ihara H, Mikami J, Nakaya R, Kusakabe T, et al. Addiction of gelling agent (pectin-calcium) to a fluid intra-gastric diet decreased pneumonia and diarrhea in patients with percutaneous endoscopic gastrostomy, a multi-center randomized control study. Journal of JSPEN 2018;33:611-6. (in Japanese).
Shimizu A. Effects of semisolid contrast agent for gastroesophageal reflex in patients after percutaneous endoscopic gastrostomy. Journal of JSPEN 2018;33:617-20. (in Japanese).
Article Metrics
Abstract View

DOI: 10.24871/2222021130-133
Refbacks
- There are currently no refbacks.