Posted by: Indonesian Children | August 26, 2010

Feeding Dysfunction in Children With Eosinophilic Gastrointestinal Diseases.

Feeding Dysfunction in Children With Eosinophilic Gastrointestinal Diseases.

Mukkada VA, Haas A, Maune NC, Capocelli KE, Henry M, Gilman N, Petersburg S, Moore W, Lovell MA, Fleischer DM, Furuta GT, Atkins D.

Pediatrics. 2010 Aug 9.

Gastrointestinal Eosinophilic Diseases Program.

Abstract

Objectives: Feeding dysfunction (FD) seen in younger children with eosinophilic gastrointestinal disease (EGID) has not been well described. Thus, our aim was to further characterize FD in children with EGIDs. Methods: A retrospective medical record analysis of 200 children seen over 12 months in a multidisciplinary Gastrointestinal Eosinophilic Diseases Program was performed. The clinical data of 33 children identified as also having FD were examined, including information obtained by history, physical examination, feeding evaluation, review of nutritional data, allergy testing and histologic assessment of mucosal biopsies. Results: Of 200 children with EGIDs, 16.5% had significant FD. The median age of this group was 34 months (range: 14-113 months). A variety of learned maladaptive feeding behaviors were reported in 93.9%. Frequent gagging or vomiting occurred in 84.8%. Food sensitivity was documented in 88% while 52% had other allergic disease. Twenty one percent were diagnosed with failure to thrive and 69.7% required individual or group feeding therapy. Forty-two percent had residual eosinophilia of >15 per HPF on esophageal biopsies performed at the time of symptoms. Conclusions: FD is prevalent in children with EGIDs often presenting as maladaptive learned feeding behaviors with altered mealtime dynamics and physical difficulties in eating mechanics. FD can persist even after eosinophilic inflammation is successfully treated. Awareness of the increased prevalence of FD in children with EGIDs with enable earlier recognition of this problem, resulting in a comprehensive, individualized treatment plan with the desired outcome of improving the development, feeding, and nutrition of these children.

References

  1. Fleischer DM, Atkins D. Evaluation of the patient with suspected eosinophilic gastrointestinaldisease.Am
  2. Liacouras CA, Spergel JM, Ruchelli E, et al.Eosinophilic esophagitis: a 10 year history in 381 children.2005;3(12):1198 –1206
  3. Kedesdy JL, Budd KS.Disorders: Biobehavioral Assessment andInterventionBrookes Publishing Co; 1998
  4. Babbit RL, Hoch TA, Coe DA. Behavioral feedingdisorders. In: Tuchman DN, Walters RL,eds.Disorders: Pathophysiology, Diagnosis, andTreatmentPublishing; 1994:77–95
  5. Sisson LA, VanHasselt VB. Feeding Disorders.In: Luselli JK, ed.and Developmental DisabilitiesNY: Springer-Verlag; 1989:45–73
  6. Pentiuk SP, Miller CK, Kaul A. Eosinophilicesophagitis in infants and toddlers.2007;22(1):44–48
  7. Satter E.and Good SenseCo; 1991:406–427
  8. Eicher PM. Feeding. In: Batshaw ML, ed.With Disabilities. 4th edMD: Paul H. Brookes Publishing Co; 1997:621– 641
  9. Morris SE, Klein MD.Comprehensive Resource for Feeding Development. Immunol Allergy Clin North. 2009;29(1):53– 63Clin Gastroenterol Hepatol.Childhood Feeding. Baltimore, MD: Paul H.Pediatric Feeding and Swallowing. San Diego, CA: SingularBehavioral medicine. New York,Dysphagia.Child of Mine: Feeding With Love. Palo Alto, CA: Bull PublishingChildren. Baltimore,Pre-feeding Skills: A2nd ed. Tucson, AZ: Therapy SkillBuilders; 1987:59 –94
  10. Wolf L, Glass RP.Disorders in Infancy: Assessment and ManagementTucson, AZ: Therapy Skill Builders; 1992
  11. Putnam P. Eosinophilic esophagitis in children:clinical manifestations. Endosc Clin N Am
  12. Nurko S, Rosen R. Esophageal dysmotility inFeeding and Swallowing.Gastrointest. 2008;18(1):11–23 PEDIATRICS Volume 126, Number 3, September 2010 e5 Downloaded fromwww.pediatrics.org. Provided by Indonesia:AAP Sponsored on August 26, 2010 patients who have eosinophilic esophagitis. Gastrointest Endosc Clin N Am 73– 89
  13. Aceves SS, Newbury RO, Dohil R, Bastian JF, Broide DH. Esophageal remodeling in pediatric eosinophilic esophagitis.Immunol
  14. Furuta GT, Liacouras CA, Collins MH, et al. Eosinophilic esophagitis in children and adults: a systematic review and consensus recommendations for diagnosis and treatment.. 2008;18(1):J Allergy Clin. 2007;119(1):206 –212 Gastroenterology 1342–1363
  15. Aceves SS, Furuta GT, Spechler SJ. Integrated approach to treatment of children and adults with eosinophilic esophagitis.. 2007;133(4): Gastrointest Endosc Clin N Am195–217
  16. Kerwin ME, Ahearn WH, Eicher PS, Burd DM. The costs of eating: a behavioral economicanalysis of food refusal. 1995;28(3):245–260
  17. Chehade M, Sampson HA, Morotti RA, Magid MS. Esophageal subepithelial fibrosis inchildren with eosinophilic esophagitis.Gastroenterol Nutr319 –328. 2008;18(1):J Appl Behav Anal.J Pediatr. 2007;45(3):

 

 

 

Supported by

PICKY EATERS CLINIC,  KLINIK KHUSUS KESULITAN MAKAN PADA ANAK

JL TAMAN BENDUNGAN ASAHAN 5 JAKARTA PUSAT, JAKARTA INDONESIA 10210

PHONE :62 (021) 70081995 – 5703646

Email : judarwanto@gmail.com

http://mypickyeaters.wordpress.com/

Clinical and Editor in Chief :

DR WIDODO JUDARWANTO, pediatrician

email : judarwanto@gmail.com,

Copyright © 2010, Picky Eaters Clinic Information Education Network. All rights reserved


Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

Categories

%d bloggers like this: