GASTROESOPHAGEAL REFLUX IN PATIENTS FED BY PERCUTANEOUS ENDOSCOPIC GASTROSTOMY (PEG) - DETECTION BY A SIMPLE SCINTIGRAPHIC METHOD

Objectives: Gastroesophageal scintigraphy has been described as a sens itive and accurate way to detect and quantitate gastroesophageal reflu x (GER). Our objectives here were to evaluate the usefulness of a modi fied scintigraphic technique in the detection of GER and lung aspirati on in patients fed by percutaneous endoscopic gastrostomy (PEG), and t o assess the incidence of GER after insertion of PEG. Further, we soug ht to examine whether or not the underlying cause of dysphagia plays a ny significant part in the causation of GER. Methods: Twenty-two patie nts, 13 with neurological dysphagia and nine with mechanical dysphagia , were studied. Each patient received 25 MBq of Tc-(99m)-tin colloid i n orange juice followed by 300 ml of normal saline through the PEG tub e. Dynamic and static images were taken immediately and at 4 h over es ophagus, stomach, and lungs. Results: Twelve patients (10 with neurolo gical dysphagia) had GER and one had aspiration into the lungs. Zn all but one patient GER occurred in the immediate postprandial period. Co nclusions: Scintigraphy is useful in assessing GER in PEG-fed patients . We also note that GER is a major problem in patients with PEG, espec ially in those with neurological dysphagia. (C) 1998 by Am. Coll. of G astroenterology.