Asunto(s)
Azatioprina/uso terapéutico , Enfermedades Inflamatorias del Intestino/tratamiento farmacológico , Adolescente , Adulto , Niño , Colitis Ulcerosa/tratamiento farmacológico , Enfermedad de Crohn/tratamiento farmacológico , Método Doble Ciego , Humanos , Mercaptopurina/uso terapéutico , Metronidazol/uso terapéuticoRESUMEN
Complex carbohydrate intolerance occurred in three of 105 patients with protracted diarrhea of infancy. Nosocomial gastroenteritis complicated a primary disorder of carbohydrate absorption (primary glucose galactose malabsorption, two; primary sucrase isomaltase deficiency, one) in all patients. Their course was characterized by protracted diarrhea, variable degrees of villus atrophy on intestinal biopsy tissue, and negative caloric balance requiring intravenous alimentation for periods varying from 6 to 16 weeks. Dietary management required rigid exclusion of all offending carbohydrates from the diet. Delay in the diagnosis of primary carbohydrate intolerance varied from 2 weeks to 6 months. Complex carbohydrate intolerance may be more common than has been reported, and should be considered in all infants with protracted diarrhea of infancy when there is persistent carbohydrate intolerance.
Asunto(s)
Errores Innatos del Metabolismo de los Carbohidratos/diagnóstico , Galactosa/metabolismo , Glucosa/metabolismo , Síndromes de Malabsorción/diagnóstico , Sacarosa/metabolismo , Errores Innatos del Metabolismo de los Carbohidratos/dietoterapia , Errores Innatos del Metabolismo de los Carbohidratos/patología , Diarrea/etiología , Humanos , Recién Nacido , Intestinos/patología , Síndromes de Malabsorción/dietoterapia , Síndromes de Malabsorción/patología , Masculino , Complejo Sacarasa-Isomaltasa/deficienciaRESUMEN
We report five children who had transient elevations in sweat electrolyte values in association with environmental deprivation. The high electrolyte values were not always associated with malnutrition, and normalized more rapidly than weight. The reason for these abnormalities is unknown. In as much as elevated sweat electrolytes are rarely associated with environmental deprivation, repeat studies are recommended before diagnosing cystic fibrosis in such children.
Asunto(s)
Electrólitos/análisis , Insuficiencia de Crecimiento/metabolismo , Carencia Psicosocial , Sudor/análisis , Preescolar , Fibrosis Quística/metabolismo , Humanos , MasculinoRESUMEN
A computerized dietary analysis program was used in an ambulatory setting to assess adequacy of intake and alterations in a variety of dietary constituents. A TRS-80 microcomputer was programmed using 1980 National Academy of Sciences Recommended Dietary Allowances. Seventy-two hour dietary intakes of 147 patients were analyzed for average intake of 13 nutrients, nutrients per kilogram body weight, comparison with 1980 RDA, and percent of total calories as carbohydrate, fat, and protein. Six groups were studied, including patients with failure to thrive without diarrhea, with diarrhea without malabsorption, with diarrhea with malabsorption, with cystic fibrosis, and with constipation, and controls. A wide range of values for different dietary constituents was found in all groups and in individual patients. This program is an easy, practical, and rapid method for analyzing dietary intake, and can be used to screen for a variety of nutritional disorders.
Asunto(s)
Fenómenos Fisiológicos Nutricionales Infantiles , Computadores , Dieta , Programas Informáticos , Niño , Preescolar , Estreñimiento , Fibrosis Quística , Diarrea , Insuficiencia de Crecimiento , Humanos , Lactante , Síndromes de Malabsorción , Estudios ProspectivosAsunto(s)
Colestasis/genética , Electrólitos/análisis , Sudor/análisis , Preescolar , Cloruros/análisis , Femenino , Humanos , Lactante , MasculinoRESUMEN
A prospective study was undertaken of 108 children referred for outpatient evaluation of chronic recurrent diarrhea. The majority of the children did not have a serious underlying disorder. Elimination diets (milk free, egg free, wheat free) were widely prescribed for the treatment of chronic diarrhea and were given for longer intervals than originally recommended. Elimination diets sometimes resulted in inadequate caloric intake and failure to thrive. Wheat (gluten)-free diets were prescribed for over one month in 59% of children without a specific diagnosis being made. These findings indicate that elimination diets are frequently misused, and prolonged adherence to elimination diets may result in nutritional damage. The indiscriminate use of wheat-free diets for the treatment of chronic diarrhea may be masking the diagnosis of celiac disease and may account for the low incidence of this disorder in the United States.