Product information and disease description Place of product in therapy Approaches to treatment Current treatment options and standard of care

Nutritional support and gastrostomy

6 evidence topics · 8 sources

Guideline recommendations on feeding support and gastrostomy

“Speech–language therapists and dieticians can support families by giving practical advice about changes in feeding routines.” (opens the source at this quote in a new tab)
“Therefore, gastrostomy placement should be considered early.” (opens the source at this quote in a new tab)

“Assessment of the adequacy and safety of nutritional intake should be performed at least annually. Provision of supplemental calories by the oral or enteral route should be undertaken in those with worsening nutritional status. Early gastrostomy insertion is likely to be required in those with unsafe swallow or inadequate nutritional intake.” (opens the source at this quote in a new tab)

Indications for a gastrostomy tube

“A gastrostomy tube (G-tube or feeding tube) is recommended when any of the following occur: a child cannot eat enough to grow or a person of any age cannot eat enough to maintain weight; aspiration is problematic; mealtimes are stressful or too long, interfering with other activities” (opens the source at this quote in a new tab)

“If the child has an unsafe swallow, gastrostomy or jejunostomy feeding is advised.” (opens the source at this quote in a new tab)

Gastrostomy at the Johns Hopkins clinic: tolerance and caregiver satisfaction

“We completed a retrospective review of 175 patients who visited the A-T Children's Center at Johns Hopkins Hospital from 2001 through 2008, and identified 28 patients with A-T (19 males, 9 females) who underwent GT placement for non-palliative reasons.” (opens the source at this quote in a new tab)
“Twenty-five (89%) patients tolerated GT placement and were a median of 5.0 (0.4-12.6) years post GT placement at the time of this investigation. Three (11%) patients died within one month of GT placement.” (opens the source at this quote in a new tab)
“In comparison to patients who tolerated GT placement, patients with early mortality were older when GT's were placed (median 24.9 vs. 12.3 years, p = 0.006) and had developed a combination of dysphagia, nutritional, and respiratory problems.” (opens the source at this quote in a new tab)
“Caregivers of patients tolerating GT placement reported significant improvements in mealtime satisfaction and participation in daily activities.” (opens the source at this quote in a new tab)

Gastrostomy at the United Kingdom national pediatric clinic

“14/101 (14%) children had a PEG, with longitudinal data available for 12. In a nested case control study, there was a trend for improvement in weight in those with a PEG (p=0.10).” (opens the source at this quote in a new tab)
“We suggest early proactive consideration of PEG from age 8 years onwards to prevent progressive growth failure.” (opens the source at this quote in a new tab)

Gastrostomy in a single-center cohort followed from 1986 to 2015

“Gastrostomy tubes were inserted in 12 patients, leading to improvement in BMI-Z from -5.1 ± 2.4 to -4 ± 2.9 (P < 0.05).” (opens the source at this quote in a new tab)

Caregiver acceptance of gastrostomy

“We know how to manage the nutritional needs of people with A-T, but do not do an adequate job of communicating this to caregivers and convincing them to use gastrostomy tubes to deliver supplemental calories early enough in life to make a difference to their children.” (opens the source at this quote in a new tab)

“Most parents are understandably reluctant to consider a feeding tube or gastrostomy, however discussion with another family with first-hand experience of the benefits can help.” (opens the source at this quote in a new tab)