Caregivers' perceptions following gastrostomy in severely disabled children with feeding problems
Child; Female; Humans; Male; Adult; Attitude to Health; Questionnaires; Treatment Outcome; Fundoplication; Time Factors; Cost of Illness; Gastrostomy; Stress; quality of life; adolescent; Preschool; Caregivers/psychology; infant; Q3 Literature Search; Parents/psychology; Nutritional Failure; Psychological/psychology; Developmental Disabilities/complications; Eating Disorders/etiology/therapy
Feeding difficulties are common in neurologically impaired children, often leading to great distress and frustration in the child and family. A gastrostomy may be advocated if oral intake is inadequate causing poor weight gain or when there is significant aspiration during feeding, or if feeding is very distressing. To find out if caregivers were happy with the outcome of gastrostomy (with fundoplication, when indicated), a 35-item questionnaire was developed and sent to 38 of them. Twenty-nine replies were received and appeared to be representative of the whole group. Coughing, choking, and vomiting improved in most cases. Weight gain improved in all in whom it had been a problem. In the majority, it became easier to give the children their medications although control of epilepsy was unchanged overall. Time spent feeding the child was reduced and many caregivers had more time to devote to other children and themselves. Only one parent regretted the operation. In children with severe disability and feeding problems, a gastrostomy (with fundoplication if there is significant reflux) can reduce symptoms of vomiting, coughing, and choking, help growth and improve quality of life in the child, when patients are properly selected.
1997
Tawfik R; Dickson A; Clarke M; Thomas AG
Developmental Medicine And Child Neurology
1997
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1111/j.1469-8749.1997.tb07376.x" target="_blank" rel="noreferrer">10.1111/j.1469-8749.1997.tb07376.x</a>
Decisions in diagnosing and managing chronic gastroesophageal reflux disease in children
Child; Humans; Biopsy; Esophagoscopy; Fundoplication; Medical History Taking; Diagnosis; Differential; Anti-Ulcer Agents/therapeutic use; Gastroesophageal Reflux/diagnosis/therapy; Proton Pumps/antagonists & inhibitors
Gastroesophageal reflux disease (GERD) presents in different ways in children, most commonly with vomiting, or with esophageal symptoms such as regurgitation, heartburn, or dysphagia. Extraesophageal symptoms and signs also frequently occur. Less well recognized is that abdominal pain is a relatively common mode of presentation. Although abdominal pain is common in school-aged children, GERD and other acid-related disorders such as peptic ulcer disease are relatively uncommon causes of such. A careful history will usually determine whether an acid-related disorder is in the differential diagnosis of abdominal pain. Early detection and treatment of GERD in children may prevent, attenuate, or heal complications such as failure to thrive or feeding refusal as well as pulmonary, ear-nose-and-throat disorders, erosive esophagitis, and peptic stricture. In children with persistent or severe symptoms and/or complications of GERD such as erosive esophagitis, the major treatment options are pharmacologic management with acid-suppressing medication, specifically proton pump inhibitors (PPIs), or antireflux surgery. For many patients, PPI treatment offers advantages over surgery. When given in adequate doses, PPIs can safely effect relief of GERD symptoms and healing of esophagitis in children. Antireflux surgery may work well in selected patients, but it carries significant risk of morbidity, including high failure rates, even in the short term. Some postoperative studies report that more than 60% of patients are back on medical treatment with proton pump inhibitors for recurrence of GERD symptoms, and a similar percentage have new symptoms that were not present before surgery. Death is uncommon but does occur and is an unacceptable risk in an otherwise healthy, low-risk individual. Laparoscopic surgery may have some disadvantages compared with open surgery, including a higher rate of redo operations. Studies show that many children undergo surgery for unclear indications, often with few preoperative diagnostic studies. The availability of highly effective medical therapy, together with more careful selection of patients for surgery, may result in better patient outcomes, with much lower operative rates.
2005
Hassall E
The Journal Of Pediatrics
2005
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1016/j.jpeds.2004.11.034" target="_blank" rel="noreferrer">10.1016/j.jpeds.2004.11.034</a>
Neurologically impaired children and digestive problems
Child; Humans; Follow-Up Studies; Prospective Studies; Treatment Outcome; Fundoplication; Enteral Nutrition; adolescent; Preschool; infant; Q3 Literature Search; Injections; disabled children; Botulinum Toxin Type A/administration & dosage; Brain Damage; Chronic/complications/therapy; France; Gastric Acidity Determination; Gastroesophageal Reflux/complications/therapy; Gastroscopy; Intramuscular; Protein-Energy Malnutrition/etiology/therapy
2006
Podevin G; Capito C; Leclair MD; Heloury Y
Archives De Pediatrie
2006
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1016/j.arcped.2006.03.041" target="_blank" rel="noreferrer">10.1016/j.arcped.2006.03.041</a>