Gastrointestinal Eosinophilic Diseases Program, Department of Pathology, Children's Hospital, Aurora, CO, USA.
Pediatrics. 2010 Sep;126(3):e672-7. doi: 10.1542/peds.2009-2227. Epub 2010 Aug 9.
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.
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.
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.
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.
嗜酸性粒细胞性胃肠道疾病（EGID）患儿中可见喂养功能障碍（FD），但尚未对此进行充分描述。因此，我们旨在进一步明确 EGID 患儿 FD 的特征。
对 12 个月内在多学科胃肠道嗜酸性粒细胞疾病项目中就诊的 200 例患儿进行回顾性病历分析。对被确定为同时存在 FD 的 33 例患儿的临床数据进行了检查，包括病史、体格检查、喂养评估、营养数据回顾、过敏检测和黏膜活检组织学评估中获得的信息。
在 200 例 EGID 患儿中，有 16.5%存在明显的 FD。该组患儿的中位年龄为 34 个月（范围：14-113 个月）。93.9%报告存在多种习得性不良喂养行为。84.8%频繁出现呛咳或呕吐。88%有食物敏感，52%有其他过敏性疾病。21%被诊断为生长迟缓，69.7%需要进行个体或小组喂养治疗。42%在症状出现时进行食管活检时仍存在＞15 个/高倍镜视野的残余嗜酸性粒细胞。
FD 在 EGID 患儿中较为常见，常表现为不良的习得性喂养行为，伴用餐时动态改变和进食力学方面的物理困难。即使嗜酸性粒细胞炎症得到成功治疗，FD 仍可能持续存在。提高对 EGID 患儿 FD 发病率增加的认识，将有助于更早地识别该问题，从而制定全面、个体化的治疗计划，最终改善这些患儿的发育、喂养和营养状况。
