Experience of using Nanny-1 formula with prebiotics in young infants with functional constipations

Background. Relevance is associated with a decrease in the number of breastfed children and the choice of breast milk substitute. Features of the composition and properties of the modern adapted formula based on goat milk — Nanny-1 with prebiotics allow it to be used in the nutrition of young infants. The purpose was to assess the clinical effectiveness of Nanny-1 formula with prebiotics in young infants with functional constipations. Materials and methods. We have examined 64 formula-fed children aged 1 to 6 months with functional constipations. Babies were divided into 2 groups: 32 of them received the adapted goat-milk-based formula Nanny-1 with prebiotics (group 1), and 32 children — cow-milk-based formula with prebiotics (group 2). The examination included laboratory studies, evaluation of weight/height parameters, dynamics of functional gastrointestinal disorders. Results. Patients of both groups had a stable increase in body weight and gain in height. After a month of taking Nanny-1 with prebiotics, the incidence of functional digestive disorders in infants of the first group decreased. The number of babies with positive dynamics of gastrointestinal disorders receiving cow-milk-based formula was less than in group 1. In most infants fed using goat-milk-based formula with a prebiotic complex, the bowel emptying was regular and soft, stool consistency improved, the number of defecations was 1–3 times a day, constipations continued in 15.6 % of children. In the group of babies who received cow-milk-based formula, constipations remained in 9 infants (28.1 %). Conclusions. Using Nanny-1 formula with prebiotics in the nutrition of infants promotes their normal physical development and a decrease in the incidence of functional constipations and other gastrointestinal disorders

Using GerdQ as a screening diagnostic method in children with gastroduodenal diseases

Background. Problem of screening for esophageal diseases in primary stages of diagnosis in children with gastroduodenal pathology is widespread. As non-invasive and economically available method, a modified Gastroesophageal Reflux Disease Questionnaire (GerdQ) is proposed for children aged 12–18 years. The purpose of the study is comparative analysis of the state of esophageal, gastric and duodenal mucosa and endoscopic pH values of the esophagus with the results of GerdQ use in children with gastroduodenal patho­logy. Materials and methods. Sixty seven children aged 12–18 years were examined. All patients underwent endoscopic study of the esophagus, stomach and duodenum with endoscopic pH measuring. The GerdQ was filled out by the children surveyed. Results. The data obtained indicate a significantly higher incidence of catarrhal and erosive esophagitis in children with destructive and catarrhal changes in the gastric mucosa and duodenum. The degree of gastroesophageal reflux and a decrease in pH values in the esophagus and stomach progressed in the presence of significant changes in the gastric mucosa. GerdQ results indicated GERD in patients with score ≥ 8. Endoscopy findings in this group were mostly catarrhal and destructive changes of esophageal mucosa with high acidity. Patients with score < 8 had mostly motility disorders (gastroesophageal reflux) and moderate increase of acidity. The results of GerdQ comparison with the data of the endoscopic study and the pH-measuring shows a significant (95 %; p < 0.05) coincidence of positive GerdQ results with pronounced endoscopic changes in the esophageal mucosa and a decrease in pH < 4 in the esophagus and < 1.2 in the stomach. Conclusions. The study shows that the sensitivity of the questionnaire is quite high and allows its use at the primary stage of diagnosis in children of middle and senior school age

Risk factors and possibilities of preventing gastroesophageal reflux disease in school-age children

Background. The article presents the main problems of early diagnosis of gastroesophageal reflux disease (GERD) in school-age children, which leads to late detection and initiation of treatment. The purpose of the study was to identify the main risk factors that may predispose the development of this disease, as well as triggers that provoke GERD in school-age children. Knowledge of risk factors can help prevent the formation of GERD in children, and, with timely diagnosis of therapy, reduce the severity of the disease and improve quality of life. Materials and methods. Open comparative study included 98 school-age children (31 girls, 67 boys) aged 6 to 18 years (mean age 14.2 years). Diagnosis of gastroesophageal reflux disease was conducted in accordance with the Order of the Ministry of Health of Ukraine dated January 29, 2013, No. 59 “On Approval of Unified Clinical Protocols for Medical Care of Children with Digestive Disorders”. During the comprehensive examination, the identification of possible risk factors was made, for which a detailed history collection was performed: the nature of the child’s nutrition and the regularity of the meal were evaluated, as well as the mode of the day, the presence and intensity of physical activity, the presence of chronic stress (psycho-traumatic situations), sleep duration, bad habits, false eating habits. Past medical history also revealed the duration of breastfeeding and the time of supplementary food introduction. Physical examination was also aimed at the detection of so-called symptoms of anxiety — “red flags” that may indicate the presence of complications or organic pathology. Results. In both age groups, boys were dominant; besides, there were significantly more children aged 13–17 years in the group with GERD. Early administration of supplements was revealed in both groups, as well as early artificial/mixed feeding. More than 85 % of children had signs of autonomic dysregulation and concomitant pathology of the upper digestive tract. Interestingly, body mass index met norms in most patients, so this risk factor was not significant. Conclusions. The study has revealed the main risk factors that contribute to the formation of GERD in children of two age groups: 6–12 and 13–17 years, and the relationship between individual risk factors with different forms of GERD was analyzed. Optimization of the primary screening diagnosis of GERD can be achieved by using adapted pediatric GERD questionnaire at the outpatient stage of medical care. It includes not only questions about typical esophageal clinical symptoms, but also extravascular and atypical GERD symptoms. Most of the risk factors and trigger factors are modified, so at the stage of primary care, the control of children’s status who are at risk of GERD, timely diagnosis and correction of risk factors, or reflux disorders which occur in the presence of these factors will prevent the development of disease or its severe course that will improve the quality of life of the patient

The role of adsorbents in the management of diarrhea syndrome in children

This article deals with the pathological conditions with diarrhea syndrome in children. Pathogenetic mechanisms of diarrhea development, peculiarities of clinical and laboratory manifestations in various diseases are considered. The main methods to control diarrhea are presented, mechanisms of sorption therapy action are considered. The classification of enterosorbents used in clinical pediatric practice is given. The characteristics of Apsorbin sachet which is registered in Ukraine as dietary supplement with enterosorption action is given. The results are presented on using Apsorbin sachet in comprehensive therapy of children with irritable bowel syndrome (type with diarrhea) and convalescent children after gastrointestinal infections

Optimization of treatment of irritable bowel syndrome in children

Background. Factors that trigger several pathophysiological mechanisms may simultaneously be involved in the occurrence of irritable bowel syndrome (IBS). Disorders of the intestinal microbiota play a significant role in the pathogenesis of the disease in children, given the characteristics of the child’s body. Changes in the composition of the intestinal microflora may be accompanied by movement disorders and impaired sensory sensitivity of the intestines, which form the basis for the formation of pain, dyspeptic manifestations and stool disorders. The lack of effect from the treatment of IBS may be due to the presence of violations of the intestinal biocenosis in the child; therefore, in accordance with the recommendations of the Rome IV criteria, it is necessary to correct the intestinal microflora. The purpose is to study the effectiveness of synbiotic Optilact® in the treatment of irritable bowel syndrome in children. Materials and methods. Thirty-three children aged 8 to 14 years with irritable bowel syndrome (variant with constipation) were examined. The diagnosis was made on the basis of clinical, paraclinical, laboratory and instrumental studies. The dietary supplement Optilact® was prescribed in order to relieve the main complaints — constipation, flatulence, to reduce pain symptoms and improve the general condition of the patient. The effectiveness of therapy was evaluated on the basis of the clinical dynamics of pain and dyspeptic complaints, reduction of constipation. The dyna­mics of coprological data was assessed by the end of the course of dietary supplement administration. Results. The findings indicate the feasibility and effectiveness of synbiotic Optilact® in children with irritable bowel syndrome (variant with constipation). The positive dynamics of pain and dyspeptic manifestations, the absence of side effects make it possible to use it in children. Conclusions. The use of the dietary supplement Optilact® in the comprehensive therapy of patients with IBS (variant with constipation) reduces pain and dyspeptic manifestations of the disease, eliminates constipation