Electrogastrography in gastrostomy-tube-fed children

Following gastrostomy tube placement some children develop gagging, retchin g, vomiting, pain, or irritability during feedings. Conventional medical ma nagement is not always successful. It is possible that intolerance of gastr ostomy tube feedings reflects an underlying motility disorder of the foregu t. The study aim was to determine whether children with gastrostomy tube fe eding difficulties demonstrate abnormal gastric electrical control activity as measured by electrogastrography. Cutaneous electrogastrography of inter pretable quality was performed in 25 feeding-tolerant and 23 feeding-intole rant children less than 10 years of age. Dominant frequencies, rhythm indic es, and postprandial power measurements were recorded during the fasting an d postprandial periods. Differences between groups were compared using the Student's t test. The groups were similar in method of gastrostomy tube pla cement, antireflux surgery, neurological impairment, duration of gastrostom y feeding dependence, formula type, volume, and administration. The feeding -tolerant group was significantly older (P < 0.01). There were no significa nt differences between groups in the mean dominant frequencies or rhythm in dices. The feeding-intolerant children had a mean postprandial power change that was significantly lower than that of the feeding tolerant group (P < 0.003), although overlap was present. Children who are intolerant of gastro stomy tube feeding have an abnormal postprandial power decrease. EGG domina nt frequency and rhythm indices are not predictive of gastrostomy feeding t olerance in predominantly neurologically impaired children.