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[Efficacy of nutrition support therapy in children with chronic diarrhea]
1Department of Gastroenterology, Children's Hospital Affiliated to Zhejiang University School of Medicine, Hangzhou 310003, China. hzcjie@163.com.
Insights
Nutrition support therapy effectively improves nutritional status and relieves symptoms in children with chronic diarrhea. This approach, alongside etiological treatment, is crucial for managing pediatric chronic diarrhea cases.
Area of Science:
- Pediatric Gastroenterology
- Clinical Nutrition
- Malnutrition Management
Context:
- Chronic diarrhea significantly impacts children's nutritional status and overall health.
- Effective management strategies for pediatric chronic diarrhea are essential.
- Nutrition support is a key component in treating complex pediatric gastrointestinal conditions.
Purpose:
- To evaluate the efficacy of nutrition support therapy in children suffering from chronic diarrhea.
- To compare outcomes across different age groups and nutritional interventions (enteral nutrition, partial parenteral nutrition + enteral nutrition, total parenteral nutrition).
Summary:
- A retrospective analysis of 48 children with chronic diarrhea revealed that nutrition support therapy, including enteral nutrition (EN) and partial parenteral nutrition (PPN) combined with EN, significantly improved nutritional markers like BMI-for-age Z-score (BAZ) and weight-for-age Z-score (WAZ).
- While 50% of cases had unknown causes, nutritional interventions led to symptom remission and improved nutritional status in most treated children.
- The <1 year age group showed a higher prevalence of moderate underweight compared to the >1 year group upon admission.
Impact:
- Nutrition support therapy serves as an effective multimodality treatment for pediatric chronic diarrhea.
- This therapeutic approach can significantly improve children's nutritional status and alleviate diarrheal symptoms.
- Findings support the integration of tailored nutrition support into the comprehensive management of pediatric chronic diarrhea.
Objective:
To investigate the efficacy of nutrition support therapy in children with chronic diarrhea.
Methods:
A retrospective analysis was performed for the clinical data of 48 children with chronic diarrhea who were hospitalized between July 2012 and July 2014. These children were divided into <1 year group (27 children) and ≤1 year group (21 children). Twenty-seven of these patients, who had malnutrition, were divided into enteral nutrition (EN) group (10 children), partial parenteral nutrition (PPN)+EN group (16 children), and total parenteral nutrition (TPN) group (1 child). The therapeutic process and outcome were compared between different age groups and children receiving different treatments.
Results:
Among the 48 children, short bowel syndrome, viral enteritis, a history of intestinal surgery, and malabsorption syndrome were common causes of chronic diarrhea, and 24 children (50%) had unknown causes. In the aspect of nutritional assessment on admission, the <1 year group had a significantly higher proportion of children with moderate underweight than the ≤1 year group (P<0.05). In the EN group, the BMI-for-age Z-score (BAZ) increased from -2.2±1.5 before treatment to -1.8±1.0 (P=0.040), and the energy supplied increased from 46±17 kcal/kg per day before treatment to 83±32 kcal/kg per day (P=0.012). In the PPN+EN group, the weight-for-age Z-score (WAZ) increased from -3.3±2.0 before treatment to -2.8±1.8 (P=0.044), and BAZ increased from -2.8±1.4 before treatment to -2.0±1.4 (P=0.012). There was only 1 child in the TPN group, whose symptoms of diarrhea were relieved after treatment. Among 27 children receiving nutritional therapy, 4 were not improved, and the other children achieved remission of symptoms and improvements in nutritional status.
Conclusions:
Besides etiological treatment, nutrition support therapy can be applied as part of multimodality therapy in children with chronic diarrhea. This can effectively improve nutritional status and relieve the symptoms of diarrhea.
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