Experience of percutaneous endoscopic gastrostomy in children with Crohn's disease

Abstract

Enteral nutrition is an important mode of treatment for Crohn's disease in children. Percutaneous endoscopic gastrostomy has been little used, even though it can facilitate the administration of an unpalatable elemental diet to an anorexic, undernourished patient. Its use is reported in 10 children with Crohn's disease. The gastrostomy was found to be more acceptable than a nasogastric tube and was associated with only minor complications. As a consequence of improved delivery of enteral nutrition, in the year after the insertion of the gastrostomy there was a reduction in prednisolone dosage in all patients, with six patients being able to stop prednisolone completely. The SD score for height also improved significantiy. It is suggested that percutaneous endoscopic gastrostomy is both useful and safe in the management of Crohn's disease in children, particularly when compliance with an elemental diet is likely to be poor.