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Effect of Blenderized Enteral Tube Feeds on Pediatric Upper Gastrointestinal Tract Physiology

Not Applicable
Recruiting
Conditions
Enteral Feeding Intolerance
Interventions
Other: Elecare Jr
Other: Nourish
Other: Real Foods Blends
Registration Number
NCT04900597
Lead Sponsor
Boston Children's Hospital
Brief Summary

Blenderized diets consist of a wide range of table foods such as fruits, vegetables, meat and legumes, pureed in a blender and administered via gastrostomy tube. In a recent study, the investigators reported that children receiving blenderized feeds via gastrostomy had fewer total admissions and respiratory admissions, total emergency room visits, and improved gastrointestinal symptom scores compared to those fed formula. The goal of this project is to understand how these diets affect gastroesophageal reflux burden.

Detailed Description

The investigators hypothesize that rates of gastroesophageal reflux will be lower in blenderized diets compared to formula. The investigators will determine if reflux burden as measured by multichannel intraluminal impedance/esophageal pH monitoring performed for clinical purposes differs between low viscosity conventional formula, medium viscosity commercial blenderized diet, and high viscosity commercial blenderized diet in 45 children receiving conventional formula via gastrostomy. All participants will receive each of the three test diets in random order in a 3-way crossover design. Results of gastric emptying scans will be recorded if done for clinical purposes.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
45
Inclusion Criteria
  • Age 1-21 years
  • G-tube
  • Able to tolerate bolus gastric feeds over 30 minutes
  • Use of conventional enteral formula
  • Undergoing impedance study for clinical purposes
Exclusion Criteria
  • History of allergy or intolerance to any component of the test diets
  • History of Nissen fundoplication (participants with suspected or documented unwrapped fundoplication will be eligible for participation)
  • Current use of non-invasive pressure support (continuous or bi-level positive airway pressure)

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
Real Foods Blends - Elecare - NourishReal Foods BlendsReal Foods Blends for first bolus, Elecare for second bolus, Nourish for third bolus
Elecare - Nourish - Real Foods BlendsReal Foods BlendsElecare for first bolus, Nourish for second bolus, Real Foods Blends for third bolus
Nourish - Real Foods Blends - ElecareElecare JrNourish for first bolus, Real Foods Blends for second bolus, Elecare for first bolus
Real Foods Blends - Elecare - NourishElecare JrReal Foods Blends for first bolus, Elecare for second bolus, Nourish for third bolus
Elecare - Nourish - Real Foods BlendsElecare JrElecare for first bolus, Nourish for second bolus, Real Foods Blends for third bolus
Nourish - Real Foods Blends - ElecareNourishNourish for first bolus, Real Foods Blends for second bolus, Elecare for first bolus
Elecare - Nourish - Real Foods BlendsNourishElecare for first bolus, Nourish for second bolus, Real Foods Blends for third bolus
Nourish - Real Foods Blends - ElecareReal Foods BlendsNourish for first bolus, Real Foods Blends for second bolus, Elecare for first bolus
Real Foods Blends - Elecare - NourishNourishReal Foods Blends for first bolus, Elecare for second bolus, Nourish for third bolus
Primary Outcome Measures
NameTimeMethod
Reflux episodes4 hours (following feed)

Number of total reflux episodes (acid and non-acid) by impedance

Secondary Outcome Measures
NameTimeMethod
Full column reflux episodes4 hours (following feed)

Total number of full-column reflux episodes by impedance

Percent of time esophageal pH < 44 hours after feed

Percent of time esophageal pH \< 4 by impedance

Average height of refluxate4 hours after feed

Average height of refluxate by impedance

Number of symptoms4 hours after feed

Frequency of pulmonary and gastrointestinal symptoms from questionnaires during impedance

Trial Locations

Locations (1)

Boston Children's Hospital

🇺🇸

Boston, Massachusetts, United States

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