Blended diets and effects on gastrointestinal symptoms in children with gastrostomy tubes: A survey study

Objectives: Interest is growing in the use of blended diets (BD) in children with gastrostomy. Evidence supporting the benefits of BD is conflicting, with limited data to assist physicians in clinical practice. The present survey aims to evaluate current use of BD in children and adolescents with gastrostomy. Methods: An online survey evaluating the use of BD in children with gastrostomy was sent to members of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition with expertise on gastrointestinal motility. The questions assessed clinical indications, level of experience, preferred diet composition, and clinical outcomes. Results: We collected 26 questionnaires filled out by members from 13 different countries. Most of the respondents (84.6%) are pediatric gastroenterologists, with 69.2% visiting gastrostomy patients on a daily/weekly basis. The majority of the sample (61.5%) declares to use BD, but only in selected conditions, and only 38.5% reports an advanced experience with BD. The main reason for BD prescription is parental request (53.8%). In addition, 57.7% prefers homemade BD compared to only 15.4% that relies on commercial BD. Finally, 69.2% states to find an impact on gastrointestinal symptoms. Positive clinical outcomes are reported for vomiting (61.1%), constipation (50%), nausea (38.9%), and bloating (38.9%). The main reason for not using BD is the non-standard nutritional composition. Conclusions: BD are commonly used in clinical practice. However, due to the lack of conclusive evidence and well-designed studies, there is great variability in diet composition and clinical indications. Given the increasing demand from caregivers and the potential positive outcomes, further studies are needed to provide insights and guide healthcare professionals in their clinical practice.