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. 2025 Mar;114(3):569-577.
doi: 10.1111/apa.17474. Epub 2024 Oct 25.

Percutaneous endoscopic gastrostomy helped to normalise feeding problems and gastrointestinal symptoms in Silver-Russell syndrome

Nataliia Muz  1 , Miriam Petersson  1 , Robert Saalman  1   2 , Jovanna Dahlgren  1   2
Affiliations

Percutaneous endoscopic gastrostomy helped to normalise feeding problems and gastrointestinal symptoms in Silver-Russell syndrome

Nataliia Muz et al. Acta Paediatr. 2025 Mar.

Abstract

Aim: This study evaluated feeding problems and gastrointestinal symptoms in children with Silver-Russell syndrome (SRS), which is a rare epigenetic disorder. It also compared the symptoms experienced during different feeding methods, including percutaneous endoscopic gastrostomy (PEG).

Methods: The national expert team for children with SRS at Queen Silvia Children's Hospital, Gothenburg, studied 46 referrals (63% male) who were born with SRS in Sweden from 1984 to 2018. Patient data were extracted from the Paediatric National Growth Hormone Registry.

Results: The medical records covered a median of 68% of the time of the patients' childhood, with a median follow-up of 9 years. Their symptoms were most prevalent during infancy and decreased when they were toddlers. Feeding problems and gastrointestinal symptoms were reported in 91% of the 46 patients, with vomiting in 57% and constipation in 46%. There were 19 children who relied on enteral feeding for their nutrition and 13 of those received PEG. Their body mass index (BMI) increased significantly 2 years after PEG started (p = 0.005).

Conclusion: Feeding problems and gastrointestinal symptoms were very common in children with SRS, but partly disappeared during childhood. Providing treatment, such as PEG, normalised the BMIs of children with SRS and reduced their symptoms.

Keywords: Silver‐Russell syndrome; body mass index; growth retardation; percutaneous endoscopic gastrostomy; rare epigenetic disorder.

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Conflict of interest statement

The authors have no conflict of interest to declare.

Figures

FIGURE 1
FIGURE 1
The numbers and percentage out of 46 patients with one or more symptoms: vomiting, nausea, constipation, abdominal pain and diarrhoea.
FIGURE 2
FIGURE 2
The frequency of patients with feeding problems, gastrointestinal symptoms and enteral feeding during childhood. Frequency divided by age group (age span in years).
FIGURE 3
FIGURE 3
(A) Frequency of patients with vomiting related to different feeding modalities (age span in years). (B) Frequency of feeding problems in patients with different feeding modalities (age span in years). Group 1 received PEG, group 2 received nasogastric tube feeding after the first month of life and group 3 received complete oral feeding. As group 4 consisted of patients with no medical history of feeding problems or GI symptoms, they are not shown. *P values are for the comparisons between group 1 versus group 2 and group 1 versus group 3 (p < 0.01).
FIGURE 4
FIGURE 4
Longitudinal changes in BMI standard deviation score (SDS) in relation to three modes of feeding and clinical symptoms. Groups 1‐3 were patients with a medical history of feeding problems and GI symptoms. Group 1 received PEG, group 2 received nasogastric tube feeding after the first month of life and group 3 received complete oral feeding. Group 4 was patients with no medical history of feeding problems or GI symptoms.
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