Clinical Studies of Intractable Diarrhea During Infancy.
- Author:
Jae Hong PARK
1
;
Cheol Hong KIM
;
Eui Jun YANG
;
Sang Wook PARK
;
Sang Wook NAM
Author Information
1. Department of Pediatrics, College of Medicine, Pusan National University, Pusan, Korea.
- Publication Type:Original Article
- Keywords:
Intractable diarrhea;
Infancy
- MeSH:
Age of Onset;
Anti-Bacterial Agents;
Breast Feeding;
Diarrhea*;
Diet;
Enterocolitis, Necrotizing;
Humans;
Infant;
Infant Mortality;
Milk;
Parenteral Nutrition, Total;
Recurrence;
Retrospective Studies;
Rotavirus;
Serum Albumin;
Weaning
- From:Journal of the Korean Pediatric Society
1998;41(7):923-930
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Intractable diarrhea during infancy is one of the major causes of infant mortality. But, its etiology, clinical courses, or methods of treatment are not well known. Therefore, we conducted a clinical approach to intractable diarrhea during infancy. METHODS: We have retrospectively evaluated clinical characteristics, laboratory findings, methods of treatment, days required for recovery, in 23 infants who were admitted with intractable diarrhea, from January 1993 to December 1996. RESULTS: The onset age was 18.4 +/- 17.8 days and the duration of diarrhea was 28.8 +/- 16.5 days. All patients were fed artificial milk before the onset of diarrhea. The possible causes of diarrhea were infection (60.8%), change of milk, milk concentration (17.4%), or an unknown origin (21.8%). Laboratory findings on admission showed hemoglobin 9.5 +/- 2.2g/dL, serum albumin 2.9 +/- 0.7g/dL. E. coli was cultured in urine in 1 case. Stool rotavirus antibody was positive in 1 case. Nineteen patients (82.6%) required total parenteral nutrition for 18.3 +/- 13.6 days and antibiotics were administered to 20 patients (86.9%). Twenty-two patients (95.7%) were fed special element formula milk. All but one who died of necrotizing enterocolitis, recovered. Special element fomula milk was used for 92.6 +/- 20.5 days after discharge, and there were no cases of recurrence. CONCLUSION: We considered appropriate oral element fomulas, total parenteral nutrition and the proper treatment of infection as important factors in future outcome of intractable diarrhea during infancy. We thought the short-term administration of special formula milk can be substituted for normal milk or a weaning diet. However, encouraging breast feeding may perhaps be a more effective way of preventing this problem.
