Heart racing after feeding through G-tube

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dbw

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My Dad (PALS) had a G-tube placed about a month ago. Since last week, he has experienced some episodes of discomfort with symptoms like increased heart rate from 60 to 90 per minute and sweating, about 10 minutes after feeding through the G-tube. It lasted about 20 minutes to 30 minutes. Then, everything went back to normal. I called to the nurse and dietitian at the home care company and the neurologist who prescribed the G-tube. They didn't have a good explanation, and suggested my Dad to see a cardiologist. I don't believe it is a heart problem. Does anyone have similar experience or know the cause of the problem? We use the common gravity approach (bolus) to feed. The formula that we use is Jevity.

Thanks,

DB
 

joelc

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The only thing I can suggest is maybe the Jevity is not sitting well any more, I have heard of this happening with others. You could try some different formula and see if that might help. Good luck!
 

dbw

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Joel, thanks for the information. We will try different formulas. Any suggestion on which one is relatively mild to stomach?
Today, we tried Ensure both through mouth and feeding tube. When it was taken through mouth at the lunch time, no discomfort at all. When fed Ensure through G-tube at dinner time, similar kind of discomfort happened, with heart racing, sweating and a little bit nausea. However, we also tried the same amount of water between lunch and dinner, no problem at all.
 

joelc

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Jevity seems to be the most widely used, from all I can tell, for people that are sensitive.

Try doing the PEG feeding at lunch and see if you still have the problem. I have a sweating time at supper everyday and it has nothing to do with feeding.

Ensure is meant to drink or put through PEG so it has too much sugar for me. There are several other formulas that other PALs use - I will do some research and let you know, maybe others here can share what they are doing.
Good luck!
 

joelc

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Here are the names of other formula options........

Carnation VHC.
predigested formula--Optimental from Ross/Abbott
Resource 2.0
Nutren 1.5
Osmolite 1.2
Nutricia fortisips
Novartis Compleat

Hope this helps a bit.
 

dbw

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Joel, thanks for the suggestion and the list of formulas. We have tried the feeding at lunch time. It was pretty much the same reaction. We also have tried to feed the same amount of water through PEG. It didn't cause any problem. So my guess is the formula. However, I still do not understand why taking Ensure orally is OK and feeding through PEG causes problem for my Father. We will try different kind of formulas sometime this week. Thanks again!
 

katsmith

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katsmith

Have youconsidered the temperature of the feeding. is it given at room temperature? my other question would be the position of the tube?
 

dbw

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katsmith, thanks for your questions. It was at room temperature. The position seems right around where the stomach is. I am not sure the exact anatomical location. We may need an X-ray or CT to verify the exact location. What is your concern about position? Do you concern that it may be too close to diaphragm, which may cause the heart palpation by stimulating or depressing some nerves, for example vagus nerve? However, his heart rate only increases after each feeding through the tube. Thanks!
 

katsmith

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I was thinking about nerve stimulation or the posibility of the tube having looped back and the only way to check position of the tube and rule it out would be xray or CT/MRI In US cost of test may be a barrier in Canada Acesswill be the barrier for a quick answer.
thanks for responding.
Katsmith
 

dbw

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I just want to give all of you a quick update. We tried several things. One approach really helped is dilution. We just did a 1:1 dilution of the formula with water. The symptom went away. Thanks everyone for the advice and help!
 

fiddleplayer51

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dbw,
Thanks for posting your dilution solution! Glad you found it.
I hope your father is doing as well as can be expected.
Best wishes,
Jane
 
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