OP‐14 EFFECT OF TUBE‐FEEDING ON BOLUS CLEARANCE TIME IN NEUROLOGICALLY IMPAIRED CHILDREN VERSUS NORMAL CHILDREN

Abstract

Aim:Neurologically impaired children are at increased risk of gastro‐esophageal reflux disease (GERD). Pathogenic factors that can lead to GERD include transient lower oesophageal sphincter relaxation and impaired oesophageal clearance. Previous studies had suggested that neurologically impaired children have increased bolus clearance time (BCT). The aim of our study is to determine the effect of (naso‐gastric) tube‐feeding on BCT in these children.Methods: Retrospective review of the multi‐channel intra‐luminal impedance‐pH (MII‐pH) results of the paediatric population performed from January 2012 to December 2014.Results:A total of 71 studies were performed. 7 studies were excluded from data analysis as these children had previous fundoplication which is known to alter oesophageal peristalsis. Of the 64 analysed, 33 were in neurologically impaired children and 32 were male. The median (range) age was 1.35 (0.03–18.58) years. 60 (93.75%) children were less than 5 years old at the time of the study.In our cohort, all the neurologically impaired children were tube‐fed. 41 (68.75%) of the children were tube‐fed; bolus fed (n = 30), continuous naso‐gastric (n = 7) or naso‐jejunal (n = 4). Based on the MII‐pH results, 16 children (25%) were diagnosed to have GERD. 9 of the neurologically‐impaired children had GERD while 7 of the neurologically normal children had GERD. There was no difference in the means of the “median BCT” in neurologically impaired versus normal children (10.42 (SD 4.27) vs 9.18 (SD 2.12) seconds, p = 0.144), or in those with or without GERD based on MII‐pH, regardless of underlying neurological status.Conclusions:Our data suggest that BCT in neurologically abnormal children who are tube‐fed do not appear to be longer than neurologically normal children, or associated with an increased risk of GERD. This suggests that other mechanisms have a greater role in conferring the increased risk of GERD in this population. Of note, “median BCT” values were also shorter in our population of predominantly young children of age less than 5.