[Secondary carbohydrate and protein intolerances following gastroenteritis]

After acute gastroenteritis, delayed recovery and protracted diarrhoea may occur, particularly in very young infants, in bottle-fed malnourished infants, and after rota virus infection. Monosaccharide and disaccharide malabsorption have been demonstrated to contribute to postenteritis problems in these children. The contribution of secondary food protein intolerance to the perpetuation of diarrhoea after gastroenteritis is less well understood. Secondary sugar intolerance is diagnosed by estimation of stool pH, Clinitest, H2 breath testing and, in some cases, direct enzyme determination from biopsy material. Diagnosis of secondary cow's milk or soy-protein intolerance has to be done by clinical challenge. Dietary therapy consists of elimination of the malabsorbed food compound. A general elimination diet (lactose-free protein hydrolysate formula) is not necessary in the majority of cases but may be life-saving in individual infants. In West European countries postenteritis problems have become less in quality and quantity during the last few years.