ABSTRACT
BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) is the preferred method for providing enteral nutritional support in patients with dysphagia. We examined gastric antral myoelectrical activity and gastric emptying before and after PEG tube placement to evaluate the effects of PEG on gastric motility. METHODS: PEG was performed in 41 patients; 21 fed by total parenteral nutrition (TPN) and 20 who received nasogastric tube feeding (NGF). Antral myoelectrical activity and gastric emptying were examined before and 4 weeks after PEG tube placement. RESULTS: The percentage of normal-range electrogastrograms (EGGs) was significantly lower in the TPN group than in the NGF group in both the pre- and postprandial periods before PEG tube placement. Enteral feeding after PEG tube placement improved gastric motility in the patients with TPN. The percentage of normal-range EGGs increased significantly after PEG tube placement in both the pre- and postprandial periods, and plasma concentrations of paracetamol increased significantly after PEG tube placement in patients with TPN. A total of 7.3% of the patients developed the complication of gastroesophageal reflux (GER) after PEG tube placement. Gastric myoelectrical activity and gastric emptying were improved in these patients with GER after PEG tube placement. In contrast, the prevalence of esophageal hiatus hernia was significantly higher in patients with GER after PEG tube placement than in patients without GER after PEG tube placement. CONCLUSIONS: Prolonged TPN with bowel rest induces physiological dysfunction of gastric motility. Enteral nutrition is the preferable physiological nutritional route. GER after PEG tube placement is not related to gastric motility. Esophageal hiatus hernia seems to be a major risk factor for GER complications after PEG tube placement. Percutaneous endoscopic gastrostomy (PEG) is the preferred method for providing enteral nutritional support in patients with dysphagia. We examined gastric antral myoelectrical activity and gastric emptying before and after PEG tube placement to evaluate the effects of PEG on gastric motility.
Subject(s)
Endoscopy, Digestive System , Enteral Nutrition , Gastric Emptying/physiology , Gastrointestinal Motility/physiology , Gastrostomy , Acetaminophen/blood , Adult , Aged , Aged, 80 and over , Analgesics, Non-Narcotic/blood , Deglutition Disorders/blood , Deglutition Disorders/physiopathology , Deglutition Disorders/therapy , Enteral Nutrition/adverse effects , Female , Gastroesophageal Reflux/blood , Gastroesophageal Reflux/etiology , Gastroesophageal Reflux/physiopathology , Hernia, Hiatal/blood , Hernia, Hiatal/etiology , Hernia, Hiatal/physiopathology , Humans , Male , Middle Aged , Parenteral Nutrition, Total , Postoperative Complications/blood , Postoperative Complications/etiology , Postoperative Complications/physiopathology , Postprandial Period/physiology , Prevalence , Treatment OutcomeABSTRACT
OBJECTIVES: To elucidate the effects of risk factors for arteriosclerosis on estimated VO(2) max and obtain useful information to advise enterprise employees. SUBJECTS: One hundred and nineteen male and 87 female enterprise employees underwent exercise tests for health evaluation in the Total Health Promotion Plan at the Fukui Occupational Health Center between April 1990 and March 1993. METHODS: Multiple regression analysis was performed using estimated VO(2) max as the dependent variable, and percent body fat, blood pressure, blood tests, habitual physical activity, number of cigarettes smoked and alcohol consumption as independent variables in the first and second year, and for yearly changes in these variables. RESULTS: The significant variables selected were as follows: in the first year, systolic blood pressure and percent body fat in males, and age in females; in the second year, diastolic blood pressure and habitual physical activity in males and systolic blood pressure in females; for yearly changes in each variable, cigarettes in males and percent body fat in females were selected. CONCLUSION: It was suggested that guidance to reduce cigarettes in males, and to keep a proper percent body fat in females would be effective in maintaining the estimated VO(2) max.
