G-tube and Formula

Some children with a Nissen fundoplication/G-tube do much better with a pre-digested formula (what we call partially hydrolyzed) which has improved gastric emptying time.Ê There are several different pre-digested formulas available for tube feeding (such as Peptamen Jr.), and you should check with your GI doc about what they recommend.Ê These formulas typically are 30 kcal/ounce

Regarding the fact that your child is able to vomit now suggests that the Nissen may have "slipped".Ê We can evaluate whether a Nissen is intact by two different methods.Ê First, to assess the anatomy, we do a "tube study" where some contrast (like an UGI) is put into the G-tube and radiographs are taken to see if any contrast goes ÒbackwardsÓ and enters the esophagus.Ê Second, to assess that the Nissen is normally functioning, we can use either a 24-hour pH probe and/or a nuclear medicine "milk scan".ÊÊ The "milk scan" can be combined with a gastric emptying scan to see whether emptying is very slow.Ê This work-up may not be needed if symptoms and weight improve with a pre-digested formula, but if she remains symptomatic, your GI Doctor may recommend the above tests

LG/TK 7-13-10