Reduced gastroesophageal reflux of semisolid contrast agent by increasing the viscosity to 10,000 mPa・s in patients after percutaneous endoscopic gastrostomy, but not in patients with severe hiatal hernia.

Abstract

Purpose: We aimed to test if the increase in viscosity of semisolid contrast agent to 10,000 mPa・s reduce the frequency of gastroesophageal reflux with or without hiatal hernia.

Methods: The severity of hiatal hernia was classified into none, mild and severe at the time of percutaneous endoscopic gastrostomy (PEG) construction in 67 patients. Every 200 mL of a mixture of a contrast agent (Gastrografin^®, Bayer) and a gel-forming additive (Easygel^®, EN Otsuka) was bolus-infused into the stomach of these patients within 2 days of PEG construction. We observed the gastroesophageal reflux of contrast agent from the beginning of infusion to one minute after the end of the infusion. We compared with the results of the previous report1).

Results: The over all frequency of gastroesophageal reflux of contrast agent with 10,000 mPa・s (9/67) was significantly lower than that using contrast agent with 6,000 mPa・s (18/66). The frequency of gastroesophageal reflux in patients without hiatal hernia (3/37) or with moderate hiatal hernia (2/21) was significantly lower than that in patients with severe hiatal hernia (4/9).

Conclusion: The increase in viscosity of semisolid contrast agent to 10,000 mPa・s reduced the frequency of gastroesophageal reflux, however not enough in patients with severe hiatal hernia.