Effectiveness of gastrostomy for improving nutritional status and quality of life in patients with epidermolysis bullosa: a systematic review

Individuals with epidermolysis bullosa (EB) may present with a broad spectrum of growth impairment and multiorgan disorders, with compromised nutritional status and quality of life. The provision of nutrients through a gastrostomy tube may minimize EB-related malnourishment but may also result in skin injuries and infections. In this systematic review we consider the current evidence about the effectiveness of gastrostomy in restoring nutritional status and improving quality of life in patients with EB. Seven studies (n = 146) met selection criteria and patients ranged in age from 6 weeks to 33 years of age. Although it is not a risk-free procedure, the placement of a gastrostomy tube is a feasible and safe alternative to provide nutritional support and to improve the quality of life of patients. What's already known about this topic? Patients with epidermolysis bullosa may have their nutritional status mildly to severely affected because of reduced caloric intake and/or increased metabolic demand. What does this study add? A review of the currently available evidence about the impact of gastrostomy on the restoration of nutritional status in patients with simplex, recessive dystrophic and generalized junctional epidermolysis bullosa. The placement of a gastrostomy tube is a feasible and safe alternative to provide nutritional support and to improve the quality of life of patients with epidermolysis bullosa. Although not a risk-free procedure, it is recommended for patients who present with a failure to thrive, problems in the oral cavity, intractable chronic constipation and high stress levels during feeding.