How Much Food Should A One Month Old Baby Eat Pros and Cons of G-Tube and Fundoplication Surgery in Children

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Pros and Cons of G-Tube and Fundoplication Surgery in Children

There are numerous reasons why a baby or child would need G-tube and fundoplication surgery at such a young age, but regardless of the reason, there are many pros and cons that parents should be aware of. Fundoplication is a surgery where the upper part of the stomach is wrapped around the lower part of the esophagus; this is usually done to treat gastroesophageal reflux disease (GERD) if medications have proven ineffective for the child. A G tube or gastrostomy tube may be placed if the child has been using another feeding tube, such as a nasogastric (NG) or nasojejunal (NJ) tube. The G-tube may also be placed to provide a method of releasing air from the stomach, in order to “burp” the child.

Reasons why some children need a G-tube and fundoplication

Surgery is certainly an option of last resort when it comes to children, but sometimes it is necessary to improve the health of patients. “Failure to Thrive” is a term often used when a child falls off the growth chart, and is an indication that the child needs more nutrition and calories. There are several conditions that could lead to a child not thriving, but the most common would probably be a combination of GERD with poor oral food intake.

It’s a vicious cycle as acid reflux irritates the esophagus, leading to bad food that can then be refluxed, usually several times a day. Sometimes the child learns to associate the taste of the regurgitated contents with food, and if the child refuses to eat, a feeding tube would be needed to ensure that the child gets the nutrition he needs daily.

However, if your child’s reflux is not being treated properly, there may be a chance that some or all of the tube feedings will be missed. This is why a G-tube and fundoplication is sometimes necessary: ​​the G-tube to feed the child through the stomach, and the fundoplication to make sure the food stays in the digestive system.

Advantages of G-tube and fundoplication surgery in children

No one can deny that babies and toddlers are at an important developmental stage in their lives. Their growth is meticulously charted, developmental milestones are marked based on how many months the child is, and even the number of wet and dirty diapers are indicators of the baby’s health. This is why it is so essential for a child to grow and gain weight. This surgery could help achieve this, simply because the G-tube would deliver the food directly into the stomach and the fundoplication would prevent it from spilling up.

Another benefit of this, if the child has been using an NG or NJ tube, is that it would help with oral feeding. NG and NJ tube placement requires a very thin, flexible tube to be placed through the nose, down the esophagus, and into the stomach or intestine. Having a tube in your nose and also the back of your throat doesn’t sound very comfortable, and having a tube holding the “lid” to your stomach open doesn’t seem to help with the reflux either. Removing this type of feeding tube would make the child much more comfortable with oral feeding and stimulation.

The disadvantage of fundoplication and infantile G-tube surgery

Of course, there are some risks associated with surgery and some possible sequelae that can negatively affect the child. As with all surgery, there is a risk of infection, and it is an ongoing battle when a G-tube is in place. To place the G-tube, the surgeon makes a “tunnel” into the stomach from a hole under left side of ribs; a PEG tube is inserted into this tunnel with one end fixed inside the stomach. The other end is available to deliver food and medicine, and often needs to be secured inside the child’s clothing.

While the G-tube is in use, there is a hole in the body that can be susceptible to infection. Another thing this hole can be susceptible to is granulation tissue, or GT; it is the skin that the body creates to fix the hole. GT is easily fixed by using a prescribed steroid cream, or if it becomes very large, it can be treated with silver nitrate in the surgeon’s office.

Fundoplication surgery prevents children from throwing up their stomach contents, often preventing them from belching too! With no way for the gas to escape through a burp, it has to go the other way, sometimes causing gas pains in the child’s intestines. The stomach lining can loosen over time, allowing the child to eventually belch.

Another possibility is that the stomach lining loosens completely, requiring another surgery to redo the fundoplication. Also, because this surgery requires using the upper part of the stomach to wrap around the esophagus, the stomach becomes smaller. As a result, a smaller volume of food is tolerated; Vomiting may occur from discomfort, and any gas in the stomach must be released using a common technique called ventilation.

Although the G-tube and fundoplication can facilitate the delivery of calories and nutrition to a child with a history of reflux and failure to thrive, it still has its disadvantages: smaller stomach volume, gas pains, burping, etc. However, if GERD has caused a child to fail to thrive and medications have failed to reduce acid reflux, a G-tube and fundoplication surgery may be the only thing that can help.

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