Celiac Disease, PKU, & AllergiesPediatrics Part BNS335 Unit 9Melinda Boyd, MPH, MHR, RD

Celiac Disease

Sensitivity to a flour protein (gluten)

Tends to run in families

Link to Type 1 DM Biopsy is essential

for diagnosis

www.advgastro.com/Celiac_Disease.htm

Symptoms of Celiac Disease

Diarrhea Steatorrhea 2-4 bowel movements daily Loss of appetite and weight Emaciation FTT in children (bloated belly)

http://www.pigur.co.il/imgceliac/celiac.jpg

Diet Therapy with Celiac Disease

Diet is only treatment. There is no cure.

The basic principle of diet therapy for celiac disease is to exclude all foods containing gluten-chiefly buckwheat, malt, oats, rye, barley, and wheat.

Table 25-1 and 25-2 for a sample food list and menu plan.

Patient Education

                                  

•Gluten-Free diet

•Gluten-Free specialty foods

•Nutritional needs

Other Helpful Information for Parents

Consider purchase of bread machine Separate toaster Separate preparation area (not always

needed if clean up is sufficient) Some restaurants have gluten free menu (PF

Changs) but also ensure no cross contamination possible

Just because there are no symptoms does not mean there is no damage being done. MUST FOLLOW DIET!

For more information… http://www.celiac.com/ some information http://www.glutenfreemall.com/ Has cookbooks, self-help books, food products Check out your local health food/natural food

stores (Like Whole Foods, Trader Joes, etc)

Any Questions???

Food AllergiesPrevalent in

childhood2-8% of Americans

has some form of food allergy

Food allergy versus food intolerance

Difficulties in Allergy Management

Even a small amount of the allergy food can cause a reaction

Some patients allergic to one item at one time are not at another

Some react to an allergen only when they are tired, frustrated, or emotionally upset.

People can be allergic to almost any food chemical

Let’ s look up some different allergies

Cow’s Milk AllergyKola Nut ProductsEggsPeas / LegumesCitrus FruitsSoyTomatoesWheat and other GrainsSpicesArtificial Food Colors

http://www.northvalleyallergy.com/_images/foodallergy_connectivity.jpg

More Information http://www.foodallergy.org/

Questions???

Phenylketonuria (PKU)

Phenylketonuria (PKU) is a genetic disorder in which a baby lacks or has very low levels of the enzyme phenylalanine hydroxylase (PAH).

www.webmd.com

Causes…

It’s inherited!Thanks Mom & Dad!

Symptoms…Symptoms usually develop within a few

months after birthEarly symptoms of PKU include a musty

odor to the skin, hair, and urine. Babies may lose weight from vomiting and frequent diarrhea, and may be irritable, have skin problems, and be sensitive to light.

If not treated the child can become developmentally delayed (DD)

Diagnosis The Guthrie test –

involves analyzing the blood drawn from a child’s heel

46 states mandate that all newborns be screened for PKU. The remaining states practice voluntary screening.

Treatment

Diet!!!! Infant formulas: Lofenalac Age-Related: Analog, Maxamaid, Maximum See Table 28-1 Table 28-2 for 1 year olds suggested

phenylalanine, energy, and protein intake Exchange Lists for Young Children

developed Table 28-4 Has Menu Plan for 9 Month Old

http://depts.washington.edu/pku/essentials.html

For more PKU information• www.pkunews.org

• http://ghr.nlm.nih.gov/condition=phenylketonuria

• www.pku.com

Any Questions???