Enteral Tube Feeding Improves Nutrition in Kids with Mitochondrial Disease, Review Suggests

Children affected by mitochondrial diseases who show nutritional deficiencies improve gastrointestinal symptoms, quality of life, and catch up on their development after receiving nutritional support from a feeding tube, according to researchers.

The study, “Enteral Tube Feeding in Pediatric Mitochondrial Diseases,” was published in the journal Scientific Reports.

People diagnosed with a mitochondrial disease often show gastrointestinal (GI) problems – previously reported to occur in 29% to 48% of patients – and nutrition deficiencies.

Now, a group of researchers reviewed 68 cases of Korean children up to age 18 with a mitochondrial disease who were had enteral tube feeding to evaluate the therapy’s potential benefits.

The children showed several GI symptoms – failure to thrive, difficulties in swallowing, vomiting, aspiration, and reduced weight that led to the tube feeding.

The most common mitochondrial disease was Leigh’s syndrome, present in 41% of the cases, followed by mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) – in 6% of the cases – and myoclonic epilepsy with ragged-red bres (MERRF), detected in 1% of the cases.

The mean age for the first enteral tube feeding procedure was around 6 years old, while the gap from first symptoms of mitochondrial disease until the feeding tube procedure was, on average, 4.6 years.

Researchers compared outcomes of tube feeding according to feeding type – nasogastric tube versus gastrostomy. In the first case, a tube is inserted through the nostril via the esophagus and into the stomach. A gastrostomy is a surgical procedure where the tube is inserted directly into the stomach.

Both feeding strategies led to positive outcomes. They improved patients’ GI symptons – the nasogastric tube in 86% and gastrostomy in 76% of the patients; and weight gain in 28% of the patients (more patients gained weight who had the gastrostomy).

The increase in developmental quotients (DQ) – a numerical indicator of a child’s growth – was detected in 10 patients without any signs of difference of effectiveness between the nasogastric tube compared to gastrostomy – a ratio of 25% versus 21%, respectively.

Overall, “enteral tube feeding could ameliorate growth failure and improve quality of life by relieving GI symptoms. Thus, the medical team should closely monitor and promptly manage symptoms indicating the need for enteral tube feeding as a part of systemic management,” the study concluded.