0
August 1984, Vol 138, No. 8 >
Article | August 1984

Treatment of Protracted Diarrhea of Infancy FREE

Russell J. Merritt, MD, PhD; Praful H. Shah, MD; Shirley L. Hack, RD; Donaby Henton; Tom Smith, RPh; Daniel W. Thomas, MD; Frank R. Sinatra, MD
[+] Author Affiliations

Reprint requests to Childrens Hospital of Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027 (Dr Merritt).


Am J Dis Child. 1984;138(8):770-774. doi:10.1001/archpedi.1984.02140460060020.
Text Size: A A A
Published online
Article
References
Comments

• Ten patients with protracted diarrhea of infancy received either 8% or 16% of 130 calories/kg/day as amino acids. Patients were treated initially with total parenteral nutrition (TPN) and subsequently with an elemental diet. Nitrogen balance was better during TPN in those who received the higher amino acid intake. No differences were noted between groups in weight gain or restoration of muscle mass. Higher levels of serum urea nitrogen and alkaline phosphatase were noted in patients with the higher amino acid intake; cholestatic liver injury developed in two of these patients. The patients receiving the higher amount of amino acid demonstrated enhanced calciuria during TPN. Other than better nitrogen balance, no clinical benefits and more undesirable side effects were observed in patients receiving 16% amino acid calories.

(AJDC 1984;138:770-774)

REFERENCES

1 +
Avery GB, Villavicencio O, Lilly JR, et al:  Intractable diarrhea in early infancy . Pediatrics 1968;;41:712-722.
2 +
Lloyd-Still JD, Shwachman H, Filler RM:  Protracted diarrhea of infancy treated by intravenous alimentation: I. Clinical studies of 16 infants . AJDC 1973;;125:358-364.
3 +
Greene HL, McCabe DR, Merenstein GB:  Protracted diarrhea and malnutrition in infancy: Changes in intestinal morphology and disaccharidase activities during treatment with total intravenous nutrition or oral elemental diets . J Pediatr 1975;;87:695-704.
4 +
MacLean WC, Lopez de Romana G, Massa E, et al:  Nutritional management of chronic diarrhea and malnutrition: Primary reliance on oral feeding . J Pediatr 1980;;97:316-323.
5 +
Whitehead RG:  The protein needs of malnourished children , in Poster JWG, Rolls BA (eds): Proteins in Human Nutrition . New York, Academic Press Inc, 1973;, pp 103-117.
6 +
Barac-Nieto M, Spurr GB, Lotero H, et al:  Body composition during nutritional repletion of severely malnourished men . Am J Clin Nutr 1979;;32:981-991.
7 +
Sherman JO, Hamley EA, Khachadurian AK:  Use of an elemental diet in infants with severe intractable diarrhea . J Pediatr 1975;;86: 518-523.
8 +
Merritt RJ, Sinatra FR, Smith GA:  Nutritional support of the hospitalized child , in Draper HH (ed): Advances in Nutritional Research . New York, Plenum Press, 1983;, vol 5, pp 77-103.
9 +
Cheng MH, Lipsey AI, Blanco V, et al:  Microchemical analysis for 13 constituents of plasma from healthy children . Clin Chem 1979;;25:692-698.
10 +
Perman JA, Barr RG, Watkins JB,  Sucrose malabsorption in children: Noninvasive diagnosis by interval breath hydrogen determination . J Pediatr 1978;;93:17-22.
11 +
Buse M, Reid S:  Leucine: A possible regulator of protein turnover in muscle . J Clin Invest 1975;;56:1250-1262.
12 +
Cahill GF Jr:  Physiology of insulin in man . Diabetes 1971;;20:785-799.
13 +
Wallace WM:  Nitrogen content of the body and its relation to retention and loss of nitrogen . Fed Proc 1959;;18:1125-1130.
14 +
Vileisis RA, Inwood RJ, Hunt CE:  Prospective controlled study of parenteral nutrition-associated cholestatic jaundice: Effect of protein intake . J Pediatr 1980;;96:893-897.
15 +
Olson RE:  The effect of variations in protein and calorie intake on the rate of recovery and selected physiological responses in Thai children with protein-calorie malnutrition , in Olson RE (ed): Protein-Calorie Malnutrition . New York, Academic Press Inc, 1975;, pp 277-297.
16 +
Bengoa JM, Sitrin MD, Wood RJ, et al:  Amino acid induced hypercalciuria during total parenteral nutrition , abstracted. Am J Clin Nutr 1983;;37:717.
17 +
Cole DEL, Zlotkin SH:  Increased sulfate as an etiologic factor in the hypercalciuria associated with total parenteral nutrition . Am J Clin Nutr 1983;;37:108-113.
18 +
Klein GL, Cannon RA, Diament M, et al:  Infantile vitamin D—resistant rickets associated with total parenteral nutrition . AJDC 1982;;136: 74-76.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

1 +
Avery GB, Villavicencio O, Lilly JR, et al:  Intractable diarrhea in early infancy . Pediatrics 1968;;41:712-722.
2 +
Lloyd-Still JD, Shwachman H, Filler RM:  Protracted diarrhea of infancy treated by intravenous alimentation: I. Clinical studies of 16 infants . AJDC 1973;;125:358-364.
3 +
Greene HL, McCabe DR, Merenstein GB:  Protracted diarrhea and malnutrition in infancy: Changes in intestinal morphology and disaccharidase activities during treatment with total intravenous nutrition or oral elemental diets . J Pediatr 1975;;87:695-704.
4 +
MacLean WC, Lopez de Romana G, Massa E, et al:  Nutritional management of chronic diarrhea and malnutrition: Primary reliance on oral feeding . J Pediatr 1980;;97:316-323.
5 +
Whitehead RG:  The protein needs of malnourished children , in Poster JWG, Rolls BA (eds): Proteins in Human Nutrition . New York, Academic Press Inc, 1973;, pp 103-117.
6 +
Barac-Nieto M, Spurr GB, Lotero H, et al:  Body composition during nutritional repletion of severely malnourished men . Am J Clin Nutr 1979;;32:981-991.
7 +
Sherman JO, Hamley EA, Khachadurian AK:  Use of an elemental diet in infants with severe intractable diarrhea . J Pediatr 1975;;86: 518-523.
8 +
Merritt RJ, Sinatra FR, Smith GA:  Nutritional support of the hospitalized child , in Draper HH (ed): Advances in Nutritional Research . New York, Plenum Press, 1983;, vol 5, pp 77-103.
9 +
Cheng MH, Lipsey AI, Blanco V, et al:  Microchemical analysis for 13 constituents of plasma from healthy children . Clin Chem 1979;;25:692-698.
10 +
Perman JA, Barr RG, Watkins JB,  Sucrose malabsorption in children: Noninvasive diagnosis by interval breath hydrogen determination . J Pediatr 1978;;93:17-22.
11 +
Buse M, Reid S:  Leucine: A possible regulator of protein turnover in muscle . J Clin Invest 1975;;56:1250-1262.
12 +
Cahill GF Jr:  Physiology of insulin in man . Diabetes 1971;;20:785-799.
13 +
Wallace WM:  Nitrogen content of the body and its relation to retention and loss of nitrogen . Fed Proc 1959;;18:1125-1130.
14 +
Vileisis RA, Inwood RJ, Hunt CE:  Prospective controlled study of parenteral nutrition-associated cholestatic jaundice: Effect of protein intake . J Pediatr 1980;;96:893-897.
15 +
Olson RE:  The effect of variations in protein and calorie intake on the rate of recovery and selected physiological responses in Thai children with protein-calorie malnutrition , in Olson RE (ed): Protein-Calorie Malnutrition . New York, Academic Press Inc, 1975;, pp 277-297.
16 +
Bengoa JM, Sitrin MD, Wood RJ, et al:  Amino acid induced hypercalciuria during total parenteral nutrition , abstracted. Am J Clin Nutr 1983;;37:717.
17 +
Cole DEL, Zlotkin SH:  Increased sulfate as an etiologic factor in the hypercalciuria associated with total parenteral nutrition . Am J Clin Nutr 1983;;37:108-113.
18 +
Klein GL, Cannon RA, Diament M, et al:  Infantile vitamin D—resistant rickets associated with total parenteral nutrition . AJDC 1982;;136: 74-76.

Correspondence

Submit a Letter
CME
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Clear Answers | Save For Later
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Comment

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

© 2013 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems