Importance of fungus colonization in failure of silicone rubber percutaneous gastrostomy tubes (PEGs).

Silicone rubber PEG tubes or replacements were recovered from 111 patients and examined for blockage, dilatations, tears, breaks, or loss of elasticity. All irregularities were stained and examined for fungus using lactophenol cotton blue stain. The intraabdominal portion of the PEG failed from obstructions, loss of elasticity, or tears related to fungus colonies in 36% of cases.

Oral Candida colonizes the stomach and gastrostomy feeding tubes.

The lumen of gastrostomy tubes is frequently colonized with Candida. To investigate the source of this contamination, 20 consecutive malnourished patients undergoing placement of a percutaneous endoscopic gastrostomy tube and ten ambulatory controls having routine upper endoscopy performed had both their oral cavity and gastric antrum swabbed and cultured. Percutaneous endoscopic gastrostomy tube recipients who after several weeks were still under our care (9 of 20) had the lumen of their tubes cultured.

Apnea and cardiopulmonary arrest during and after endoscopy.

Ten patients developed apnea or cardiopulmonary arrest during or following endoscopy in more than 10,000 consecutive endoscopies. These complications occurred in patients over the age of 60 years with many associated diseases. Four of the reactions occurred close to the time of giving intravenous medication, the majority after the stimulation of the procedure had ended, usually more than 30 min after the last dose of medication.

Explosion-safe, enema-free, nutritious colonoscopy preparation using a prepackaged formula diet.

Breath hydrogen and methane concentrations were normal before morning colonoscopy in 72 ambulatory patients randomly assigned to Ensure or clear liquid diet preparation for 48 hours. Mechanical bowel preparation was equal with each diet using an evening-laxative and morning-enema regimen and with Ensure using two consecutive evenings of laxatives without enemas. Ensure is an explosion-safe, mechanically acceptable, nutritionally adequate method of colonoscopy preparation.