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Case report
Farrell valve relieves bloating in gastrostomy patient
  1. Alison Phippen1,
  2. Elaine Brennan1,
  3. John Ealing2,3,
  4. Samantha Kay4,5 and
  5. David Waterman5,6
  1. 1St Ann's Hospice, Manchester, UK
  2. 2Manchester MND Care Centre, Salford Royal NHS Foundation Trust, Salford, UK
  3. 3Department of Medicine, The University of Manchester, Manchester, UK
  4. 4Department of Palliative Care, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK
  5. 5St Ann’s Hospice, Manchester, UK
  6. 6Department of Palliative Care, Stockport NHS Foundation Trust, Manchester, UK
  1. Correspondence to Dr Alison Phippen, St Ann’s Hospice, St Ann’s Road North, Heald Green SK8 3SZ, UK; aphippen{at}sah.org.uk

Abstract

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.

  • Farrell Valve
  • gastric pressure relief bags
  • enteral tube feeding
  • motor neurone disease
  • bloating
  • diarrhoea
  • constipation
  • palliative care.

https://doi.org/10.1136/bmjspcare-2017-001375

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    Footnotes

    • Contributors EB and AP involved in initial conception of use of the Farrell valve for this patient. AP acquired the data. AP, EB, JE, SK and DW involved in interpreting the data, revising the work critically for important intellectual content and final approval of the published version.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; internally peer reviewed.