Malnutrition and the Ways of its Correction in Infants with Food Intolerance

O.H. Shadrin, T.L. Marushko, T.Yu. Radushinska

Abstract


Objective: to examine the status of digestion and the efficiency of correction of its disorders in infants with food intolerance. Patients and methods. We observed 40 infants (from 6 months to 3 years of life) with food intolerance, including 14 children with gastrointestinal food allergy, 26 — with non-allergic food intolerance caused by organic or functional disorders of the gastrointestinal tract. Clinical and paraclinical studies (clinical observations, stool test, ultrasound examination) were performed during the treatment. Results. All children had clinical manifestations of malnutrition caused by exocrine pancreatic insufficiency, as indicated by the corresponding clinical signs and symptoms of maldigestion according to coprogram parameters. When using pancreatin-contaning enzyme preparation Ermital 10 000 in the combination treatment of infants with food intolerance, a significant clinical effect has been observed in almost 90 % of children. In 77.5 % of infants, coprogram parameters were completely normal on the 14th day of treatment. Conclusions. In the pathogenesis of malnutrition of children with food intolerance, essential role is played by the exocrine pancreatic insufficiency, making inclusion of pancreatin-contaning enzyme preparation in the therapy pathogenetically reasonable. High clinical efficacy of Ermital 10 000, no side effects allow to recommend it for use in young children.


Keywords


infants; food intolerance; malnutrition; pancreatin

References


Белоусова Е.А., Никитина Н.В., Цодиков Г.В. Оптимизация схем лечения хронического панкреатита ферментными препаратами // Фарматека. — 2008. — Т. 13. — С. 103-108.

Гасилина Т.В., Бельмер С.В. Болезни поджелудочной железы у детей. Первичная и вторичная экзокринная панкреатическая недостаточность // Лечащий врач. — 2010. — № 6. — С. 6-10.

Захарова И.Н., Коровина Н,А., Зайденварг Г.Е., Еремеева А.В., Катаева Л.А. Коррекция относительной панкреатической недостаточности у детей c синдромом избыточного бактериального роста в тонкой кишке // Вопросы практической педиатрии. — 2009. — Т. 4, № 2. — С. 28-33.

Казак С.С. Вторинна екзокринна недостатність підшлункової залози у дітей та підлітків // Мистецтво лікування. — 2008. — № 3. — С. 14-16.

Маев И.В., Кучерявый Ю.А. Желудочное кислотообразование и хронический панкреатит: насколько сильна взаимо­связь? // Рос. журн. гастроэнтерол., гепатол., колопроктол. — 2008. — № 3. — C. 4-14.

Охлобыстин А.В. Боль при панкреатите: проблема и пути ее решения // Рос. журнал гастроэнтерол., гепатол., колопроктол. — 2012. — Т. 22, № 1. — С. 64-70.

Самур П.К., Кінг К. Харчування в педіатрії. — Львів: Медицина світу, 2012. — 562 с.

Сенаторова А.С., Омельченко Е.В. Поджелудочная железа и энзимология в педиатрии // Дитячий лікар. — 2013. — № 4. — С. 25-30.

Урсова Н.И. Функциональные нарушения билиарного тракта у детей: причины, диагностика, терапия // Фарматека. — 2013. — № 1. — С. 26-32.

Шапошникова Ю.Н. Пищевая аллергия и пищевая непереносимость: современный взгляд на проблему // Сучасна гастроентерологія. — 2008. — № 4(42). — С. 90-101.

Шумилов П.В., Дубровская М.И., Юдина О.В. и др. Поражения желудочно-кишечного тракта у детей с пищевой аллергией // Трудный пациент.— 2007.— № 10.— С. 19-25.

Ammoury R., Croffie J. Malabsorptive Disorders of Childhood // Pediatrics in Review. — 2010. — Vol. 31, № 10. — P. 407-416.

Bohn L., Storsrud S., Tornblom H., Bengtsson U., Simren M. Self-reported food-related gastrointestinal symptoms in IBS are common and associated with more severe symptoms and reduced quality of life // Am. J. Gastroenterol. — 2013. — Vol. 108. — P. 634-641.

Caras S., Boyd D., Zipfel L., Sader-Struckmeier S. Evaluation of stool collections to measure efficacy of PERT in subjects with exocrine pancreatic insufficiency // J. Pediatr. Gastroenterol. Nutr. — 2011. — Vol. 53, № 6. — P. 634-640.

Carlson M.J., Moore C.E., Tsai C.M., Shulman R.J., Chumpitazi B.P. Child and parent perceived food-induced gastrointestinal symptoms and quality of life in children with functional gastrointestinal disorders // J. Acad. Nutr. Diet. — 2014. — Vol. 114. — P. 403-413.

Ewald N., Raspe A., Kaufmann C. Determinants of exocrine pancreatic function as measured by fecal elastase-1 concentrations (FEC) in patients with diabetes mellitus // Eur. J. Med. Res. — 2009. — Vol. 14(3). — P. 118-122.

Hill R.J. The role of food intolerance in functional gastrointestinal disorders in children // Reprinted from Australian Family Phisician. — 2014. — Vol. 43, № 10. — P. 686-689.

Huml M., Kobr J., Siala K. Gut peptide hormones and paediatric type 1 diabetes mellitus // Physiol. Res. — 2011, Мay 16 [Epub ahead of print]. PubMed PMID: 21574763.

Kuhn R.J., Eyting S., Henniges F., Potthoff A. In vitro comparison of physical parameters, enzyme activity, acid resistance, and pH dissolution characteristics of enteric-coated pancreatic enzyme preparations: Implications for clinical variability and pharmacy substitution // Pediatr. Pharmacol. Ther. — 2007. — Vol. 12. — P. 115-128.

Kurowski K., Boxer W.R. Food allergies: detection and management // Am. Fam. Physician. — 2008. — Vol. 77(12). — P. 1678-1686.

Lohr J.M., Hummel F.M., Pirilis K.T., Steinkamp G., Kor­ner A., Henniges F. Properties of different pancreatin preparations used in pancreatic exocrine insufficiency // Eur. J. Gastroenterol. Hepatol. — 2009. — Vol. 21. — P. 1024-1031.

Mossner J., Keim V. Treatment with pancreatic enzymes // Dtsch. Arzteblatt. Int. — 2011. — Vol. 108. — P. 578-582.

Pasqui F., Poli C., Colecchia A., Marasco G., Festi D. Adverse Food Reaction and Functional Gastrointestinal Disorders: Role of the Dietetic // Approach. J. Gastrointestin. Liver Dis. — 2015. — Vol. 24, № 3. — P. 319-327.

Spee L.A., Lisman-Van L.Y., Benninga M.A., Bierma-Zeinstra S.M., Berger M.Y. Prevalence, characteristics, and management of childhood functional abdominal pain in general practice // Scand. J. Prim. Health Care. — 2013. — Vol. 31. — P. 197-202.

Spomer N., Klingmann V., Lerch C., Stoltenberg I., Meissner T., Breitkreutz J. Multi-particulates — the solution for children? // Arch. Dis. Child. — 2012. — Vol. 97. — P. 283-286.

Us A. Chronic pancreatitis in children: Current knowledge in diagnosis and treatment // J. of Pediatric Sciences. — 2011. — Vol. 3, № 4. — P. 98-112.




DOI: https://doi.org/10.22141/2224-0551.1.69.2016.73709

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