Department of Human Nutrition, Department of Dietetics, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, Jordana 19, 41-808 Zabrze, Poland.
Poradnia Żywienia Dzieci w Bielsku Białej/Child Nutrition Clinic in Bielsko-Biała, 43-309 Bielsko Biała, Poland.
Nutrients. 2022 Apr 22;14(9):1739. doi: 10.3390/nu14091739.
Avoidant/Restrictive Food Intake Disorder (ARFID) is a relatively new disease entity in DSM-5 and ICD-11. This disorder continues to pose a diagnostic and therapeutic challenge for many professionals. This disorder can affect people of all ages. The most characteristic pattern is considered to be a lack of interest in eating or avoidance of food intake, which may result in nutritional deficiencies, weight loss or lack of expected weight gain, dependence on enteral feeding or dietary supplements, and impaired psychosocial functioning. This disorder cannot be explained by a current medical condition or co-occurring other psychiatric disorders, but if ARFID co-occurs with another disorder or illness, it necessarily requires extended diagnosis. Its treatment depends on the severity of the nutritional problem and may include hospitalization with multispecialty care (pediatrician, nutritionist, psychologist, psychiatrist, neurologist). The nutritional management strategy may include, inter alia, the use of Food Chaining, and should in the initial stage of therapy be based on products considered "safe" in the patient's assessment. The role of the dietitian in the management of a patient with ARFID is to monitor weight and height and nutritional status and analyze the foods that should be introduced into the food chain first.
回避/限制型食物摄入障碍(ARFID)是 DSM-5 和 ICD-11 中的一个相对较新的疾病实体。这种疾病仍然对许多专业人员构成诊断和治疗挑战。这种疾病可以影响所有年龄段的人。最典型的模式被认为是对进食缺乏兴趣或避免进食,这可能导致营养不足、体重减轻或预期体重增加不足、依赖肠内喂养或膳食补充剂以及心理社会功能受损。这种疾病不能用当前的医疗状况或同时存在的其他精神障碍来解释,但如果 ARFID 同时存在另一种障碍或疾病,则必然需要延长诊断。其治疗取决于营养问题的严重程度,可能包括多学科治疗的住院治疗(儿科医生、营养师、心理学家、精神科医生、神经科医生)。营养管理策略可能包括使用食物连锁,并且在治疗的初始阶段应基于患者评估中认为“安全”的产品。营养师在 ARFID 患者管理中的作用是监测体重、身高和营养状况,并分析应首先引入食物连锁的食物。