Wharton B, Howells G, Phillips I
Br Med J. 1968 Dec 7;4(5631):608-11. doi: 10.1136/bmj.4.5631.608.
Diarrhoea was a common problem in the kwashiorkor seen in Kampala, contributing to the mortality and delay in recovery. Enteric infection was found in only a few children (8%), but when present it caused particularly severe diarrhoea and was frequently complicated by septicaemia.Sugar intolerance often occurred to lactose and other sugars, both monosaccharide and disaccharide. The children were most commonly intolerant of lactose, and some of these may have had a hereditary lactase deficiency.Antibiotics are rarely indicated for the treatment of diarrhoea in kwashiorkor in Kampala. If reducing substances are found in the stool of a child on a milk diet, a diet based on sucrose is substituted, and if intolerance persists a fructose diet is given. A few children are intolerant of all sugars, including fructose, and for these the prognosis is grave.
腹泻是在坎帕拉所见的夸希奥科病中的常见问题,会导致死亡率上升和康复延迟。仅在少数儿童(8%)中发现肠道感染,但一旦出现,就会引起特别严重的腹泻,并且经常并发败血症。对乳糖和其他糖类(单糖和双糖)的不耐受情况经常发生。儿童最常见的是对乳糖不耐受,其中一些可能存在遗传性乳糖酶缺乏。在坎帕拉,治疗夸希奥科病腹泻很少使用抗生素。如果在以牛奶为饮食的儿童粪便中发现还原物质,就改用基于蔗糖的饮食,如果不耐受情况持续存在,就给予果糖饮食。少数儿童对所有糖类包括果糖都不耐受,对这些儿童来说,预后很严峻。