Efficacy and tolerance of gastrostomy feeding in Japanese muscular dystrophy patients

Although muscular dystrophy patients often have feeding difficulty and need long-term enteral nutrition, only a few reports have described gastrostomy feeding in these patients. This study was designed to evaluate the efficacy and tolerance of gastrostomy feeding in patients with muscular dystrophy. We performed a retrospective, multicenter study on 144 patients with muscular dystrophy who received gastrostomy feeding between 2007 and 2009 in 25 neuromuscular centers in Japan. There were 77 Duchenne muscular dystrophy (median age at gastrostomy placement 26 years, range 13–47 years), 40 myotonic dystrophy (median age 54.5 years, range 13–70 years), 11 Fukuyama congenital muscular dystrophy (median age 22 years, range 13–29 years), 5 limb girdle muscular dystrophy (median age 62 years, range 43–78 years), and 5 facioscapulohumeral muscular dystrophy (median age 52 years, range 28–67 years) patients. Many benefits including amelioration of malnutrition, swallowing difficulty and respiratory status were observed after the introduction of gastrostomy feeding. Especially in patients with Duchenne muscular dystrophy, mean body weight significantly increased after gastrostomy placement. Although most complications, which are commonly observed in other populations, were tolerable, respiratory failure and peritonitis were important concerns. These findings suggest that gastrostomy placement at an appropriate time is advisable in patients with muscular dystrophy.