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JPEN J Parenter Enteral Nutr. 2011 May;35(3):375-9. doi: 10.1177/0148607110377797.

Pureed by gastrostomy tube diet improves gagging and retching in children with fundoplication.

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Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.



Children with feeding disorders requiring Nissen fundoplication may develop gagging and retching following gastrostomy feedings. We developed a "pureed by gastrostomy tube" (PBGT) diet in an attempt to treat these symptoms and provide adequate nutrition and hydration.


Children post- fundoplication surgery with symptoms of gagging and retching with gastrostomy feedings were selected from our interdisciplinary feeding team. An individualized PBGT diet was designed to meet the child's nutrition goals. The child's weight gain was recorded at each follow-up visit. A telephone survey was performed to determine parents' perceptions of the child's symptoms and oral feeding tolerance.


Thirty-three children (mean age, 34.2 months) participated in the trial. Average weight gain on the PBGT diet was 6.2 g/d. Seventeen children (52%) were reported to have a 76%-100% reduction in gagging and retching. Twenty-four children (73%) were reported to have a ≥ 50% decrease in symptoms. No child had worsened symptoms on the PBGT diet. Nineteen children (57%) were reported to have an increase in oral intake on the PBGT diet.


A PBGT diet is an effective means of providing nutrition to children with feeding disorders. In children post-fundoplication surgery, a PBGT diet may decrease gagging and retching behaviors.

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