Percutaneous Endoscopic Gastrostomy in the Enteral Feeding of the Elderly
Today we are faced with an aging society that may develop malnutrition because of dysphagia related to dementia, stroke, and malignancy seen often in the elderly. The preferred form of nutritional supplementation for this group is enteral nutrition, and the most appropriate long-term method is by us...
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| Format: | Article |
| Language: | English |
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Taiwan Society of Geriatric Emergency and Critical Medicine (TSGECM)
2011-09-01
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| Series: | International Journal of Gerontology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1873959811001116 |
| _version_ | 1818507947407310848 |
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| author | Huan-Lin Chen Shou-Chuan Shih Ming-Jong Bair I.-Tsung Lin Chia-Hsien Wu |
| author_facet | Huan-Lin Chen Shou-Chuan Shih Ming-Jong Bair I.-Tsung Lin Chia-Hsien Wu |
| author_sort | Huan-Lin Chen |
| collection | DOAJ |
| description | Today we are faced with an aging society that may develop malnutrition because of dysphagia related to dementia, stroke, and malignancy seen often in the elderly. The preferred form of nutritional supplementation for this group is enteral nutrition, and the most appropriate long-term method is by use of a gastrostomy. Percutaneous endoscopic gastrostomy (PEG) was first introduced in 1980 as an alternative to the traditional operative procedure and rapidly became the preferred procedure. In geriatric patients, the principal indications are neurological dysphagia and malnutrition, related to an underlying disease or anorexia-cachexia in very elderly. PEG is contraindicated in the presence of respiratory distress, previous gastric resection, total esophageal obstruction, coagulation disorders and sepsis in the elderly. Common complications include wound infection, leakage, hemorrhage, and fistula in the general population, but aspiration pneumonia is the major case of death in this group. Risks and complications of PEG must be discussed with patients and their families; and the decision for percutaneous endoscopic gastrostomy insertion should only be made after careful consideration and discussion between managing physicians, allied health professionals, and the patient and/or family. Four ethical principles may help make feeding decisions: beneficence, non-maleficence, autonomy and justice. Attentive long-term care after tube replacement is mandatory. Acceptance of percutaneous endoscopic gastrostomy placement by patients and their families tends to increase once favorable outcomes are offered. |
| first_indexed | 2024-12-10T22:25:05Z |
| format | Article |
| id | doaj.art-5566f95a464044d0ac2094e082ccb824 |
| institution | Directory Open Access Journal |
| issn | 1873-9598 |
| language | English |
| last_indexed | 2024-12-10T22:25:05Z |
| publishDate | 2011-09-01 |
| publisher | Taiwan Society of Geriatric Emergency and Critical Medicine (TSGECM) |
| record_format | Article |
| series | International Journal of Gerontology |
| spelling | doaj.art-5566f95a464044d0ac2094e082ccb8242022-12-22T01:31:12ZengTaiwan Society of Geriatric Emergency and Critical Medicine (TSGECM)International Journal of Gerontology1873-95982011-09-015313513810.1016/j.ijge.2011.09.040Percutaneous Endoscopic Gastrostomy in the Enteral Feeding of the ElderlyHuan-Lin Chen0Shou-Chuan Shih1Ming-Jong Bair2I.-Tsung Lin3Chia-Hsien Wu4Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Mackay Medicine, Taitung-Branch, Taipei, TaiwanDivision of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, TaiwanDivision of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Mackay Medicine, Taitung-Branch, Taipei, TaiwanDivision of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Mackay Medicine, Taitung-Branch, Taipei, TaiwanDivision of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Mackay Medicine, Taitung-Branch, Taipei, TaiwanToday we are faced with an aging society that may develop malnutrition because of dysphagia related to dementia, stroke, and malignancy seen often in the elderly. The preferred form of nutritional supplementation for this group is enteral nutrition, and the most appropriate long-term method is by use of a gastrostomy. Percutaneous endoscopic gastrostomy (PEG) was first introduced in 1980 as an alternative to the traditional operative procedure and rapidly became the preferred procedure. In geriatric patients, the principal indications are neurological dysphagia and malnutrition, related to an underlying disease or anorexia-cachexia in very elderly. PEG is contraindicated in the presence of respiratory distress, previous gastric resection, total esophageal obstruction, coagulation disorders and sepsis in the elderly. Common complications include wound infection, leakage, hemorrhage, and fistula in the general population, but aspiration pneumonia is the major case of death in this group. Risks and complications of PEG must be discussed with patients and their families; and the decision for percutaneous endoscopic gastrostomy insertion should only be made after careful consideration and discussion between managing physicians, allied health professionals, and the patient and/or family. Four ethical principles may help make feeding decisions: beneficence, non-maleficence, autonomy and justice. Attentive long-term care after tube replacement is mandatory. Acceptance of percutaneous endoscopic gastrostomy placement by patients and their families tends to increase once favorable outcomes are offered.http://www.sciencedirect.com/science/article/pii/S1873959811001116elderlyenteral feedinggeriatric patientnutritionpercutaneous endoscopic gastrostomy |
| spellingShingle | Huan-Lin Chen Shou-Chuan Shih Ming-Jong Bair I.-Tsung Lin Chia-Hsien Wu Percutaneous Endoscopic Gastrostomy in the Enteral Feeding of the Elderly International Journal of Gerontology elderly enteral feeding geriatric patient nutrition percutaneous endoscopic gastrostomy |
| title | Percutaneous Endoscopic Gastrostomy in the Enteral Feeding of the Elderly |
| title_full | Percutaneous Endoscopic Gastrostomy in the Enteral Feeding of the Elderly |
| title_fullStr | Percutaneous Endoscopic Gastrostomy in the Enteral Feeding of the Elderly |
| title_full_unstemmed | Percutaneous Endoscopic Gastrostomy in the Enteral Feeding of the Elderly |
| title_short | Percutaneous Endoscopic Gastrostomy in the Enteral Feeding of the Elderly |
| title_sort | percutaneous endoscopic gastrostomy in the enteral feeding of the elderly |
| topic | elderly enteral feeding geriatric patient nutrition percutaneous endoscopic gastrostomy |
| url | http://www.sciencedirect.com/science/article/pii/S1873959811001116 |
| work_keys_str_mv | AT huanlinchen percutaneousendoscopicgastrostomyintheenteralfeedingoftheelderly AT shouchuanshih percutaneousendoscopicgastrostomyintheenteralfeedingoftheelderly AT mingjongbair percutaneousendoscopicgastrostomyintheenteralfeedingoftheelderly AT itsunglin percutaneousendoscopicgastrostomyintheenteralfeedingoftheelderly AT chiahsienwu percutaneousendoscopicgastrostomyintheenteralfeedingoftheelderly |