Bowie M D, Hill I D, Mann M D
Department of Paediatrics and Child Health, University of Cape Town.
S Afr Med J. 1988 Mar 19;73(6):343-5.
Ongoing acute diarrhoea in infancy may respond to a change from a cows' milk to a soya-based formula. This is usually ascribed to the change in carbohydrate content of the feed but the ideal carbohydrate composition of the soya feed is uncertain. Twenty infants with severe watery diarrhoea persisting 2 days after initial rehydration and refeeding with a cows' milk formula were randomly allocated to one of two soya-based formulas. In one the carbohydrate was a mixture of sucrose and glucose polymers and in the other all the carbohydrate glucose polymers. No advantage was noted for either formula. Approximately 50% of each group responded to dietary change. The prompt cessation of diarrhoea and the disappearance of evidence of carbohydrate malabsorption suggests the response is due to the removal of lactose from the diet. Those infants that did not respond had evidence of continuing carbohydrate malabsorption and were not simply lactose-intolerant. The pathogenesis of this carbohydrate malabsorption and the possible relationship to small-bowel bacterial overgrowth requires further investigation.
婴儿期持续的急性腹泻可能会因从牛奶配方奶换成大豆配方奶而有所缓解。这通常归因于喂养食物中碳水化合物含量的变化，但大豆喂养食物的理想碳水化合物组成尚不确定。20名患有严重水样腹泻的婴儿在最初补液并用牛奶配方奶重新喂养2天后仍持续腹泻，他们被随机分配到两种大豆配方奶中的一种。一种配方奶中的碳水化合物是蔗糖和葡萄糖聚合物的混合物，另一种配方奶中的所有碳水化合物都是葡萄糖聚合物。两种配方奶均未显示出优势。每组约50%的婴儿对饮食变化有反应。腹泻迅速停止以及碳水化合物吸收不良的证据消失表明，这种反应是由于饮食中乳糖的去除。那些没有反应的婴儿有持续碳水化合物吸收不良的证据，并非仅仅是乳糖不耐受。这种碳水化合物吸收不良的发病机制以及与小肠细菌过度生长的可能关系需要进一步研究。
