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Complex carbohydrate intolerance: diagnostic pitfalls and approach to management
J D Lloyd-Still1, R Listernick, G Buentello
1Department of Pediatrics, Children's Memorial Hospital, Northwestern University, Chicago, IL 60614.
The Journal of Pediatrics
|May 1, 1988
Summary
Complex carbohydrate intolerance can occur in infants with prolonged diarrhea, often linked to underlying absorption issues. Early diagnosis and strict dietary changes are crucial for managing this condition in infants.
Area of Science:
- Pediatrics
- Gastroenterology
- Nutrition
Background:
- Protracted diarrhea in infancy can stem from various causes, including carbohydrate malabsorption.
- Nosocomial gastroenteritis can complicate primary disorders of carbohydrate absorption.
Observation:
- Three out of 105 infants with protracted diarrhea presented with complex carbohydrate intolerance.
- Patients experienced prolonged diarrhea, villus atrophy, and negative caloric balance, necessitating intravenous alimentation.
Findings:
- Primary glucose galactose malabsorption and primary sucrase isomaltase deficiency were identified as underlying causes.
- Diagnosis delays ranged from 2 weeks to 6 months, highlighting a potential underdiagnosis.
Implications:
- Complex carbohydrate intolerance may be more prevalent than previously thought in infants with persistent diarrhea.
- Consideration of complex carbohydrate intolerance is vital for infants with protracted diarrhea and ongoing carbohydrate malabsorption.
- Rigid dietary exclusion of offending carbohydrates is key for effective management.