Pectin added to enteral feed reduces reflux in children with cerebral palsy

Last Updated: 2008-05-01 13:22:00 -0400 (Reuters Health)

NEW YORK (Reuters Health) – Use of pectin as a food thickener appears effective in reducing manifestations of gastroesophageal reflux disease (GERD) in children with cerebral palsy, Japanese researchers report in a paper published on April 16th in BMC Gastroenterology.

Dr. Reiko Miyazawa of Gunma University Graduate School and colleagues note that use of thickeners is an established method for decreasing episodes of regurgitation or vomiting in infants. However, it is not known whether this approach is effective for vomiting and chronic respiratory symptoms in children with cerebral palsy.

To investigate, the researchers studied 18 children who were neurologically impaired because of cerebral palsy, and who had GERD. They were randomized to a high-pectin diet with a 2:1 ratio of enteral formula to pectin, or a low-pectin diet employing a 3:1 ratio.

Monitoring showed that the median proportion of time during which lower and upper esophagus pH values were below 4 was significantly decreased in the high-pectin group compared with the low-pectin group (1.6% versus 9.2%).

The number of daily reflux episodes and their duration was also significantly decreased and the median number of vomiting episodes was significantly lower in the high-pectin group (1.0 versus 2.5).

The researchers found that pectin did cause gastric retention, and they note that it might have adverse effects on fat absorption and intestinal solubility or absorption of ferrous iron.

Summing up, Dr. Miyazawa told Reuters Health that "pectin liquid could reduce vomiting and respiratory symptoms in children with cerebral palsy and gastroesophageal reflux."

She added that "it might also be considered as an adjunct to pharmacological therapy for GERD."

BMC Gastroenterol 2008;11.