The
differential diagnosis of chronic diarrhea varies markedly with
age. In infants, it is usually a problem with formula intolerance.
Because there is up to a 50% crossover intolerance between milk
and soy, the infant should be given an extensively hydrolyzed formula.
If such intervention is delayed, he or she may develop intractable
diarrhea of infancy. Most affected toddlers have either irritable
colon of infancy or protracted viral enteritis with low-grade mucosal
injury and are consuming hypertonic feedings. In either case, institution
of a high-fat, low-carbohydrate diet that includes whole milk often
results in significant improvement. Dietary lactose rarely is a
problem. A likely cause of diarrhea among children and adolescents
is inflammatory bowel disease. With the exception of toddlers,
chronic diarrhea suggests the presence of significant organic disease.
JPEN J Parenter Enteral Nutr 1985 May-Jun;9(3):361-3
Beneficial effects of fasting and low carbohydrate diet in D-lactic
acidosis associated with short-bowel syndrome.
Ramakrishnan T, Stokes P.
A case of D-lactic acidosis in an 18-yr-old man with a short bowel is reported.
The diagnosis, suspected on clinical grounds, was confirmed by serum and urine
levels of D- lactate. Our studies revealed that an ad libitum diet was associated
with elevated D-lactate levels and "nothing per oral" and 10% carbohydrate diet
regimens caused a drop in D- lactate levels. We recommend npo and low carbohydrate
diet as preferred alternatives to antibiotics in some patients with D-lactic
acidosis. The literature is reviewed. |