G-tube Removal

Question

My daughter had a Nissen-Fundoplication procedure done over 10 years ago. She currently eats and drinks by mouth. She does not use her G-tube. Is the Nissen still functional even though now she can burp? Can the G-tube be removed? Has this been done with other children with CdLS? What are the consequences?

Answer of our experts

Sure it can be removed. If it has been over 10 years then it is unlikely to close if you just take it out. Some surgeons will try that anyway and if it is still leaking after a couple of weeks they will close the stoma (usually a short outpatient surgery). I would talk to the surgeon who did the tube and Nissen or another general surgeon if they are not available and her gastroenterologist doctor. It shouldn't matter if the Nissen is intact or not if she is doing well

CP/TK 7-13-10

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Recommendation(s)

Reflux

R32

Consider always gastro-oesophageal reflux disease (GORD) in any individual with CdLS owing to its frequency and wide variability in presentation, which includes challenging behaviour.

R33

Modification of nutrition and proton pump inhibitors (PPI) are the first-line treatments of GORD. Anti-reflux medications need to be used to their maximum dosage. Surgical interventions for GORD should be limited to those individuals with CdLS in whom nutritional and medical treatments have been unsuccessful or airway safety is at risk.

R34

If GORD symptoms persist, endoscopy should be strongly considered whilst an individual with CdLS is still in paediatric care.

R35

Surveillance for Barrett’s Oesophagus needs to be discussed with and decided together with the family, balancing the potential gain in health and burden for the individual with CdLS.

Recommendation(s)

Gastrointestinal Problems

R28

Every new born suspected or proven to have CdLS should be carefully evaluated for signs and symptoms consistent with gastrointestinal malformations.

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Please take note that the Ask the Expert service is comprised of volunteer professionals in various areas of focus. Answers are not considered a medical, behavioral, or educational consultation. Ask the Expert is not a substitute for the care and attention your child’s personal physician, psychologist, educational consultant, or social worker can deliver.

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G-tube Removal

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