Delayed Gastric Emptying

[pittsburghgal]

Does anyone know what medications can help delayed gastric emptying? My husband has a PEG and gets 4 feedings a day by a pump. Sometimes when I connect him for a feeding there is still Jevity in the stomach from the prior feeding 3 hours earlier. He only takes Zantac twice a day for reflux. He is often having pain after the feedings now.

Sharon

 

[Ells]

Is he getting enough time to digest it in the first place, I wonder?
How fast is the feed going in? i.e. mls/h.
If the feed is 1.0kcal/1.0ml, maybe a higher kcal/ml would be better - lower volume of feed for same calories. (mine is 1.5kcal/1.0ml)


Domperidone may help move food along, but is not for long-term use.

 

[Diane H]

Reglan speeds gastric emptying.

 

[lgelb]

Does he need 4 feedings daily? A higher cal formula /blenderized food less often? Blending your own might also afford you the opportunity to see what foods/liquids might help. I think we talked about trying warmer, spicier, etc.

As Diane says, Reglan can help but does have more risks long-term.

 

[KimT]

Can you reduce to three feedings and add some coconut oil to a higher calorie food? Both fat and fiber delay gastric emptying but reducing to three higher calorie meals might be worth a try.

I've always had slow transit time but I eat about 1,200 calories for lunch so that covers a small dinner.

 

[affected]

Sharon there is an option of a pump to do an overnight feed. Some PALS find this works really well for them as it really kind of drip feeds them while they sleep, so no overfull feelings at all. You could have all his nutrition going in through the night, or 50 or 60% of it and give some through the day. Whatever works best is worth experimenting with. It sure seems that 3 hours between feeds is not enough if he experiences pain, bloated feeling or nausea.

If the problem is simply that there seems to be something in the stomach when you connect up, I wouldn't worry about that without symptoms as I mentioned above.

Meds can help, but as already noted none are great for the long term, so I would think about the feeding routine to see if it will help.

 

[pittsburghgal]

Thanks for all the replies. He is on Jevity 1.2 cal at a rate of 380 ml/hr. I will see if we can go to a higher calorie fluid with less volume.

Initially we were told to use a rate of 120 ml/hr over 17 hours which was too difficult because he was almost constantly attached to the pump. This continued while sleeping but he was told to sleep in a sitting position during the feedings because he does have severe reflux. This position did not work because his neck would flex when asleep and he developed severe neck pain.

I did talk to him about the possibility of blenderized food but he said that if he can't eat food by mouth he would rather just take the Jevity.

Sharon

 

[lgelb]

Even if he wants to stay with formula, the brand may make a difference. Some are corn syrup-based like Jevity and others are not.