Farrell valve relieves bloating in gastrostomy patient

• Published in: BMJ supportive & palliative care Vol. 7; no. 3; pp. 258 - 260
• Main Authors: Phippen, Alison, Brennan, Elaine, Ealing, John, Kay, Samantha, Waterman, David
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.09.2017
• Subjects: Abdomen; Amyotrophic lateral sclerosis; Constipation; Deglutition Disorders - drug therapy; Diarrhea; Enteral Nutrition - instrumentation; Family medical history; Gastrostomy; Hospice Care; Humans; Male; Middle Aged; Motor Neuron Disease; Motor neurone disease; Nutrition; Ostomy; Palliative Care; Parenteral nutrition; Patients; Postoperative Complications - drug therapy; United Kingdom > UK; United States > US; Ireland; Illinois; constipation; bloating; enteral tube feeding; motor neurone disease; gastric pressure relief bags; Farrell Valve; diarrhoea; palliative care
• ISSN: 2045-435X; 2045-4368
• DOI: 10.1136/bmjspcare-2017-001375

Dysphagia and weight loss are experienced by up to 80% of patients with motor neuron disease (MND). Enteral tube feeding can benefit these patients but side effects including fullness, bloating, diarrhoea and constipation are frequent and can lead to non-compliance. Changes in feed formulation, regimens and the use of prokinetic medication can help symptoms. We describe a case where the use of gastric pressure relief bags during enteral feeding improved symptoms of bloating in a hospice inpatient with MND. Symptoms recurred when these were not used, which were only partially relieved by manual venting of the gastrostomy tube. We suggest that this simple, non-pharmacological approach to bloating may provide opportunities for symptom relief in the palliative care setting.