Children with epilepsy often have feeding difficulties and need to be fed by tube. The feeding problems can be aggravated by the high fat content of the ketogenic diet.
The following is a list of the common types of g-tubes, courtesy of Ward Scarff:
A good source of information on g-tubes and related matters is The Gastrostomy Support Page (link not working) by Denise B. This has a superb collection of links on subjects like gastrostomy and fundoplication. It has particularly good information on mailing lists and links of more general interest.
Another good source of information on g-tubes is the Gtube Faq-O-Matic . This is a cooperative site run by Ward Scarff, with a miscellany of information relating to g-tubes.
The best source of parent information on the g-tube is the G-tube mailing list which is run by Ward Scarff.
The Children's Motility Disorder Foundation (link not working) provides a lot of information on eating disorders, the g-tube and related matters.
Another good source of general information is the Introduction to GERD (Gastro-oesophageal Reflux Disease) from Astra Merck Inc, which reviews many matters related to the g-tube.
Often the use of a g-tube aggravates problems with reflux, and doctors commonly recommend a further operation - a (Nissen) fundoplication (link not working). Unlike the insertion of a g-tube, this is a major operation, although it is now less traumatic when laparascopic (keyhole) surgery is used. We suggest you should be very cautious if a fundoplication is recommended. At a minimum you should ask your doctor about the risks and about possible long term complications.
A number of drugs are used with the g-tube to combat reflux, including cisapride and ranitidine. Further drugs are used to assist with emptying the stomach, including propulsid and omeprazole. However, if your child has brain damage, you should make sure that metoclopramide (reglan) is NOT used. See the paper Neurological side effects associated with unnecessary use of metoclopramide in children by Abdullah Abdulaziz Al Zaben
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(checked: 13 November 2002)
(update 3.2: 13 November 2002)
(issue 3: 16 February 2002)