Background: Data on the efficacy of the newly established dietetic treatment of Crohn's disease (CD), the CD exclusion diet (CDED), are scarce. The aim of this study was to provide real-world data on the efficacy of CDED in comparison with exclusive enteral nutrition (EEN) for remission induction.
Methods:A retrospective analysis of children diagnosed with CD who were treated with CDED + partial EN (PEN) or with EEN was performed. Eighty percent of the children assigned to CDED + PEN underwent 1-2 weeks of EEN prior to CDED + PEN. For all children, data from the medical charts were extracted before the introduction of diet therapy and at the end of EEN or CDED + PEN phase 1.Results: A total of 61 patients (49.2% females; median age, 14.4 years [minimum: 6.7, maximum: 17.9]) were included in the study; 42 children (68.9%) achieved remission, 27 of 41 (65.9%) received EEN and 15 of 20 (75.0%) received CDED + PEN. There was no significant difference in the failure of nutrition therapy between the two groups (P = .469). Patients receiving CDED + PEN had significantly higher weight gain (P = .002) and increases in body mass index z-score (P = .001) compared with patients who received EEN alone.
Conclusion:Treatment with CDED + PEN (with prior 1-2 weeks of EEN) has comparable efficacy to EEN therapy alone in inducing remission in children with CD, and it leads to better weight gain. Further studies are needed to confirm these results.
PurposeThe aim of this study was to describe functional gastrointestinal disorders (FGID) presented in a tertiary medical center, characteristics of patients and results of the diagnostic work-up together with an outcome during the follow up.MethodsThis was a retrospective, single center, observational study including all patients who were diagnosed with FGID based on Rome III criteria from January to December 2015 in tertiary medical center.ResultsOverall 294 children were included (mean age, 8.9 years [range, 1–18 years]; 165 females). Majority had functional constipation (35.4%), followed by functional abdominal pain (30.6%), irritable bowel syndrome (17.0%), functional dyspepsia (12.6%), functional nausea (3.4%) and abdominal migraine (1.0%). Regression model found that only significant factor associated with improvement of symptoms is the establishment of the functional diagnosis at the first visit (hazard ratio, 2.163; 95% confidence inverval, 1.029–4.544). There was no association between improvement of symptoms and presence of alarm signs/symptoms (weight loss, nocturnal symptoms and severe vomiting) at diagnosis. Furthermore, in pain symptoms (functional abdominal pain, irritable bowel syndrome, dyspepsia) no treatment positively correlated with pain improvement.ConclusionRegardless of the initial diagnosis of FGID, positive diagnosis at the first visit increases a chance for resolution of symptoms.
The majority of children with cerebral palsy (CP) have feeding difficulties and are especially prone to malnutrition. The early involvement of a multidisciplinary team should aim to prevent malnutrition and provide adequate nutritional support. Thorough nutritional assessment, including body composition, should be a prerequisite for the nutritional intervention. As in typically-developed children nutritional support should start with dietary advice and the modification of oral feeding, if safe and acceptable. However, for prolonged feeding, in the presence of unsafe swallowing and inadequate oral intake, enteral nutrition should be promptly initiated and early gastrostomy placement should be evaluated and discussed with parents/caregivers. Gastrointestinal problems (oropharyngeal dysfunction, gastroesophageal disease, and constipation) in children with CP are frequent and should be actively detected and adequately treated as they can further worsen the feeding process and nutritional status.
The aim of this study was to investigate the role of Lactobacillus reuteri DSM 17983 in the treatment of functional constipation in children. The trial was a single-center randomized, double-blind, placebo-controlled study. Patients were allocated into the 2 groups; intervention group which received L reuteri DSM 17983 and lactulose and placebo group which received placebo and lactulose. Due to small recruitment rate study was terminated prematurely; therefore, only 33 children (12 girls, median age 4.5 years, range 2-16) were randomized. There was no difference between groups in the stool frequency, stool consistency, pain, soiling rate and dose of the lactulose. This study found that L reuteri DSM 17938 adds no benefit to the treatment of constipation in children. Due to small sample size, these results, however, should be interpreted with caution.
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