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[Dysphagia] Treatment of GER for patient with G-tube



If medication fails to benefit the patient, speak to the physician regarding the possibility of a J-tube, which has ofren helped my patients with similar issues.
 
John 
 
-----Original Message-----
From: Vikki Stefans <vstefans@george.ach.uams.edu>
To: Irene Campbell-Taylor <eripley@yahoo.com>
Cc: dysphagia@b9.com
Sent: Wed, 28 Sep 2005 18:34:21 -0500 (CDT)
Subject: Re: [Dysphagia] Treatment of GER for patient with G-tube


I'm a lot more inclined to treat with an acid reducer than a motility agent also. Motility drugs have a relatively indirect effect on reflux, just aiding gastric emptying, while lower acid content of reflux makes it less irritating and damaging to tissues in the respiratory tract. 
 
Are you keeping upright, HOB elevated at night, using small frequent feeds, etc.? 
 
Vikki Stefans, M.D., pediatric physiatrist (rehab doc for kids) at UAMS 
and Arkansas Children's Hospital. Working Mom of Sarah T. and Michael C., 
and wife of Henry Stefans. Every mom is a working mom!- OK, dads too. 
 
On Tue, 27 Sep 2005, Irene Campbell-Taylor wrote: 
 
> 
> From: "Hart, Liza" <Liza.Hart@northernhealth.ca> 
> Subject: [Dysphagia] Treatment of GER for patient with G-tube 
> 
> His family physician is concerned that the patient is 
> experiencing GER now with the g-tube, and asked whether I had come 
> across any literature re: using motility drugs to treat GER in patients 
> with g-tubes. 
> 
> *** Drug induced parkinsonism is the most common side effect of motility > modifiers such as Reglan (metoclopramide) and the most common cause of > prescription of anti-parkinson medications although, of course, they do > not work as the patient does not have PD but extrapyramidal syndrome > resulting from the motility modifier. 
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