Assessment of gastrointestinal symptoms in neurologically impaired children with PEG using peptide versus casein based formulae

Abstract Background Nutritional interventions are a key strategy for sustaining general health in children with neurological impairment. Whey-based formulae have been shown to reduce gastroesophageal reflux and accelerate gastric emptying. Casein protein, on the other hand, precipitates in the stoma...

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Main Authors: Sara Tarek, Ayman E. Eskander, Alaa Mohamed Younis, Christine G. Salama, Walaa ElNaggar
Format: Article
Language:English
Published: SpringerOpen 2024-11-01
Series:Egyptian Pediatric Association Gazette
Subjects:
Online Access:https://doi.org/10.1186/s43054-024-00336-5
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author Sara Tarek
Ayman E. Eskander
Alaa Mohamed Younis
Christine G. Salama
Walaa ElNaggar
author_facet Sara Tarek
Ayman E. Eskander
Alaa Mohamed Younis
Christine G. Salama
Walaa ElNaggar
author_sort Sara Tarek
collection DOAJ
description Abstract Background Nutritional interventions are a key strategy for sustaining general health in children with neurological impairment. Whey-based formulae have been shown to reduce gastroesophageal reflux and accelerate gastric emptying. Casein protein, on the other hand, precipitates in the stomach's acidic environment, slowing down gastric emptying. Methods This is a prospective observational study that included 34 children with severe neurological impairment between 2–14 years old of both sexes who underwent percutaneous endoscopic gastrostomy (P.E.G) tube insertion, gastrointestinal dysfunction symptoms and nutritional status were compared after 6 months between those fed either peptide-based (100% whey) or casein-based formula. We aimed in the current study to determine whether peptide-based formula reduces gastroesophageal reflux episodes and improves symptoms of poor feeding tolerance compared to casein-based formula, and to evaluate the impact of both formulae on the nutritional status of those children. Results Using peptide-based, 100% whey protein formula was associated with improved feeding tolerance and reduced gastrointestinal issues such as constipation (p-value = 0.016), reflux, and vomiting episodes (p-value = 0.034). Unlike patients who obtained the casein-based formula, patients who received the peptide-based formula exhibited significant improvement in swallowing ability 6 months after PEG insertion when compared to pre-insertion (p-value = 0.002). Conclusion Whey-based formula is better recommended for neurologically impaired children who have poor swallowing abilities, constipation, reflux, and vomiting episodes.
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spelling doaj-art-e757a5e6d06c4f36a5aab83f3b07d21d2024-11-17T12:15:00ZengSpringerOpenEgyptian Pediatric Association Gazette2090-99422024-11-0172111110.1186/s43054-024-00336-5Assessment of gastrointestinal symptoms in neurologically impaired children with PEG using peptide versus casein based formulaeSara Tarek0Ayman E. Eskander1Alaa Mohamed Younis2Christine G. Salama3Walaa ElNaggar4Departments of Pediatrics, Kasr Alainy School of Medicine, Cairo UniversityDepartments of Pediatrics, Kasr Alainy School of Medicine, Cairo UniversityDepartments of Pediatrics, Kasr Alainy School of Medicine, Cairo UniversityDepartments of Pediatrics, Kasr Alainy School of Medicine, Cairo UniversityDepartments of Pediatrics, Kasr Alainy School of Medicine, Cairo UniversityAbstract Background Nutritional interventions are a key strategy for sustaining general health in children with neurological impairment. Whey-based formulae have been shown to reduce gastroesophageal reflux and accelerate gastric emptying. Casein protein, on the other hand, precipitates in the stomach's acidic environment, slowing down gastric emptying. Methods This is a prospective observational study that included 34 children with severe neurological impairment between 2–14 years old of both sexes who underwent percutaneous endoscopic gastrostomy (P.E.G) tube insertion, gastrointestinal dysfunction symptoms and nutritional status were compared after 6 months between those fed either peptide-based (100% whey) or casein-based formula. We aimed in the current study to determine whether peptide-based formula reduces gastroesophageal reflux episodes and improves symptoms of poor feeding tolerance compared to casein-based formula, and to evaluate the impact of both formulae on the nutritional status of those children. Results Using peptide-based, 100% whey protein formula was associated with improved feeding tolerance and reduced gastrointestinal issues such as constipation (p-value = 0.016), reflux, and vomiting episodes (p-value = 0.034). Unlike patients who obtained the casein-based formula, patients who received the peptide-based formula exhibited significant improvement in swallowing ability 6 months after PEG insertion when compared to pre-insertion (p-value = 0.002). Conclusion Whey-based formula is better recommended for neurologically impaired children who have poor swallowing abilities, constipation, reflux, and vomiting episodes.https://doi.org/10.1186/s43054-024-00336-5Whey proteinFeeding toleranceNeurological impairmentSwallowing ability
spellingShingle Sara Tarek
Ayman E. Eskander
Alaa Mohamed Younis
Christine G. Salama
Walaa ElNaggar
Assessment of gastrointestinal symptoms in neurologically impaired children with PEG using peptide versus casein based formulae
Egyptian Pediatric Association Gazette
Whey protein
Feeding tolerance
Neurological impairment
Swallowing ability
title Assessment of gastrointestinal symptoms in neurologically impaired children with PEG using peptide versus casein based formulae
title_full Assessment of gastrointestinal symptoms in neurologically impaired children with PEG using peptide versus casein based formulae
title_fullStr Assessment of gastrointestinal symptoms in neurologically impaired children with PEG using peptide versus casein based formulae
title_full_unstemmed Assessment of gastrointestinal symptoms in neurologically impaired children with PEG using peptide versus casein based formulae
title_short Assessment of gastrointestinal symptoms in neurologically impaired children with PEG using peptide versus casein based formulae
title_sort assessment of gastrointestinal symptoms in neurologically impaired children with peg using peptide versus casein based formulae
topic Whey protein
Feeding tolerance
Neurological impairment
Swallowing ability
url https://doi.org/10.1186/s43054-024-00336-5
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