Journal of the Korean Pediatric Society 1998;41(7):923-930.
Published online July 15, 1998.
Clinical Studies of Intractable Diarrhea During Infancy
Jae Hong Park, Cheol Hong Kim, Eui Jun Yang, Sang Wook Park, Sang Wook Nam
Department of Pediatrics, College of Medicine, Pusan National University, Pusan, Korea
영아 난치성 설사의 임상적 고찰
박재홍, 김철홍, 양의준, 박상욱, 남상욱
부산대학교 의과대학 소아과학교실
Correspondence: 
Jae Hong Park, Email: 1
Abstract
Purpose
: Intractable diarrhea during infancy is one of the major causes of infant mortality. But, its etiology, clinical courses, or methods of treatment are not well known. Therefore, we conducted a clinical approach to intractable diarrhea during infancy.
Methods
: We have retrospectively evaluated clinical characteristics, laboratory findings, methods of treatment, days required for recovery, in 23 infants who were admitted with intractable diarrhea, from January 1993 to December 1996.
Results
: The onset age was 18.4¡¾17.8 days and the duration of diarrhea was 28.8¡¾16.5 days. All patients were fed artificial milk before the onset of diarrhea. The possible causes of diarrhea were infection (60.8%), change of milk, milk concentration (17.4%), or an unknown origin (21.8%). Laboratory findings on admission showed hemoglobin 9.5¡¾2.2g/dL, serum albumin 2.9¡¾0.7g/dL. E. coli was cultured in urine in 1 case. Stool rotavirus antibody was positive in 1 case. Nineteen patients(82.6%) required total parenteral nutrition for 18.3¡¾13.6 days and antibiotics were administered to 20 patients(86.9%). Twenty-two patients(95.7%) were fed special element formula milk. All but one who died of necrotizing enterocolitis, recovered. Special element fomula milk was used for 92.6¡¾20.5 days after discharge, and there were no cases of recurrence.
Conclusion
: We considered appropriate oral element fomulas, total parenteral nutrition and the proper treatment of infection as important factors in future outcome of intractable diarrhea during infancy. We thought the short-term administration of special formula milk can be substituted for normal milk or a weaning diet. However, encouraging breast feeding may perhaps be a more effective way of preventing this problem.
Key Words: Intractable diarrhea, Infancy


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