Lactose intolerance in allergic enterocolitis in infants

Background. Food allergy in the infancy is manifested clinically in damage to the skin and gastrointestinal tract. Allergic inflammation of the intestinal mucosa is accompanied by damage to the structure of enterocytes, which can lead to a significant reduction in the lactase enzyme on their apical surface. Materials and methods. Sixty-two children aged 2 months to 1 year with allergic enterocolitis were examined. To diagnose lactase deficiency, a hydrogen breath test with food lactose load was performed using portable monitor for determining hydrogen (H2) concentration in the exhaled air — Gastro+ Gastrolyzer manufactured by Bedfont Scientific Ltd. (UK). Results. Comprehensive assessment of the results of a hydrogen breath test with food lactose load revealed the presence of lactase deficiency and lactose-dependent small intestinal bacterial overgrowth in children with allergic enterocolitis: in protein-induced enterocolitis syndrome — in 70.3 and 14.8 % of cases, respectively, in protein-induced enteropathy — in 100.0 and 41.6 %, in protein-induced proctocolitis — in 36.0 and 32.0 % of infants, respectively. Conclusions. According to the results of a hydrogen breath test with food lactose load, 40 (62.5 %) infants with allergic enterocolitis have been diagnosed with lactose intolerance and 17 (26.6 %) — with lactose-dependent small intestinal bacterial overgrowth that are secondary and need correction in the acute period of treatment for the underlying disease

The results of prospective multicenter study of the effectiveness of amino acid formula in infants with severe atopic dermatitis and allergy to cow’s milk proteins

The article presents the main results of prospective multicenter study of effectiveness of using amino acid formula in diet therapy for the infants with severe atopic dermatitis (AD) and allergy to cow's milk protein (CMP). The study was conducted in 5 centers of Ukraine and included 30 infants with severe atopic dermatitis (EASI score > 18) aged from 29 days to 11 months. 22 patients completed the study. Diet therapy considered administration of amino acid formula containing 100 % free amino acids, for 4 weeks. Evaluation of clinical effectiveness of AD and allergy to CMP diet therapy with amino acid formula was carried out on the 7th, 14th and 28th day after reaching the full daily volume of the formula. Provocative test was performed on the 28th day with extensively hydrolyzed whey protein formula followed with evaluation of immediate and late reactions. Infants with severe AD (EASI score > 18) were characterized by impairment of several organs and systems: in 68 % of cases skin symptoms were associated with the gastrointestinal signs like change in stool frequency (constipation, diarrhea), appearance of pathological admixtures in feces (mucus, blood), vomiting, and others. With administration of amino acid formula significant decrease in severity of skin (98 %) and gastro-intestinal manifestations of food allergy (82 %) were seen. Amino acid formula was well tolerated by children with severe AD and, if needed, it might be used as a therapeutic formula for an exclusive feeding of infants with severe allergies to CMP. Duration of the diet therapy should not be less than 4 weeks. High effectiveness of this formula in infants with AD was proved by parents and doctors