1. Trier Js. Celiac Sprue. N Eng J Med 1991

may interfere with metabolism

IM = intramuscular; USRDA = United States Recommended Dietary Allowance.

IM = intramuscular; USRDA = United States Recommended Dietary Allowance.

should he made oil an individual basis, however. Minor Food sensitivities and intolerances may occur during a flare but generally do not persist and are not sufficiently important to warrant elimination from the child's diet.-0

Nutritional support and monitoring are essential in the pediatric patient with IBD to minimize malnutrition and growth failure. The use of specialized enteral formulas versus pharmaceutical therapy will continue to be widely debated. In many parts of the world, enteral diets are the treatment of choice for children with Crohn's disease and should be considered when medically appropriate.

References

1. Walker-Smith JA. Celiac disease. In: Walker WA. Durie PR. Hamilton JR. et al. Pediatric gastrointestinal disease. St Louis: Moshy; 1996.

2. Amil DJ. Walker-Smith J. Down's syndrome and coeliae disease. J Pediatr Gastroenterol Nutr 1990.10:41-3.

3. Branski D. Troncone R. Celiac disease: a reappraisal. J Pediatr 1998;133:181-7.

4. Trier JS. Celiac sprue. N Engl J Med 1991 ;325( 24): I 709-19.

5. Kumar PJ. Farthing MG. Oals and celiac disease. N Engl J Med 1995:333( 16): 1075-6.

6. Williams CL. Bollella M. Wynder EI.. A new recommendation for dietary fiber in childhood. Pediatrics 1995:96|5):985-8.

7. Cummings JH. Constipation, dietary fibre and the control of large bowel function. Postgrad Med J 1983:1:1206.

8. Duggan C. Santosham M. Glass RI. Centers for Disease Control and Prevention. The management of acute diarrhea in children: oral rehydration, maintenance, and nutritional therapy. MMWR !992;4l(No. RR-16): I-20.

9. Duggan C, Nurko S. Feeding the gut: the scientific basis for continued enteral nutrition during acute diarrhea. J Pediatr 1997;131:801-8.

10. Brown K. Peerson J. Fontaine O Use of nonhuman milks in the dietary management of young children with acule diarrhea: a meta-analysis of clinical trials. Pediatries 1994:93:17-27.

I I. Brow n K. Perez F, Peerson J, el al. Effect of dietary fiber (so> polysaccharide) on the severity, duration, and nutritional outcome of acute, watery diarrhea in children. Pediatrics 1993: 92:241-7.

12. International Working Group on Persistent Diarrhea. Evaluation of an algorithm for Ihe treatment of persistent diarrhea: a multicentre study. Bull World Health Organ 1996: 74:479-89.

13. Orenstein SR. Enteral versus parenteral therapy for intractable diarrhea of infancy: a prospective, randomized trial. J Pediatr 1986; 109(2):277-86.

14. Klish WJ. Chronic diarrhea. In: Walker WA. Durie PR. Hamilton JR. ct al. Pediatric gastrointestinal disease. 2nd ed. St. l.ouis: Mosby: 1996.

15. Suare/ FL. Savuiano DA. l.cvitl MD. A comparison of symptoms after the consumption of milk or lactose-hydrolyzed milk by people with self-reported severe lactose intolerance. N Eng J Med 1995:333:1-4.

16. Bousvaros A. Inflammatory bowel disease. Int Semin Paediatr Gastroenterol Nutr 1997 June:6(2):2-3.

17. Kanof ME. Lake AM. Bayless TM. Decreased height velocity in children and adolescents before diagnosis of Crohn's disease. Gastroenterology 1988(95 ):6:1523-7.

IX. O'Morain C. Segal AW. Levi AJ. Elemental diet as primary treatment of acute Crohn's disease: a controlled trial. BMJ 1984:288:1859-62.

19. Riguard D. Cosnes J. Le Quintree Y. et al. Controlled trial comparing two types of enteral nutrition in treatment of active Crohn's disease: elemental v polymeric diet. Gut 1991:32: 1492-7.

20. Pearson M. Teahon K. Levi AJ. Bjarnason 1. Food intolerance and Crohn's disease. Gut 1993:34:783-7.

Additional Resources Celiac Disease Support Groups

American Celiac Society Dietary Support Coalition Contact: Annette Bentley 58 Musano Court. West Orange. NJ 07052-4114 201-325-8837

E-mail: bentleac®'umdnj.edu

Celiac Sprue Association

Contact: Leon Rottman

P.O. Box 31700. Omaha, NE 68131-0700

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