Stepwise diet management in pediatric gastrointestinal graft versus host disease

Koç N., Gündüz M., Fatih Azık M., Tavil B., Gürlek-Gökçebay D., Özaydın E., ...More

Turkish Journal of Pediatrics, vol.58, no.2, pp.145-151, 2016 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 58 Issue: 2
  • Publication Date: 2016
  • Doi Number: 10.24953/turkjped.2016.02.004
  • Journal Name: Turkish Journal of Pediatrics
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.145-151
  • Keywords: Children, Diet management, Gastrointestinal graft versus host disease, Hematopoeietic stem cell transplantation
  • Hacettepe University Affiliated: No

Abstract

Gastrointestinal tract is one of the major systems affected by graft-versus-host disease (GVHD). Injury to the gut during conditioning therapy before stem-cell transplantation (SCT) plays a pivotal role in the initiation of inflammatory stimuli. We reviewed medical records of the patients who underwent SCT between April 2010 and June 2013 in our center. A stepwise upgrade diet was given to the children with acute GI-GVHD (Gastrointestinal GVHD) including parenteral and enteral nutrition. A total of 105 patients underwent SCT and seven patients developed grade III-IV acute GI-GVHD. Total parenteral nutrition (TPN) was initiated to all patients after the diagnosis of GI-GVHD and minimal enteral nutrition (1-2 ml/kg/day standard pediatric enteral formula/special meat soup) was given to the patients. GI-GVHD improved in all patients with no change in body weight, and recovery to a normal diet took 10-30 days. Stepwise diet management of oral nutrition contributed to rapid improvement of grades III-IV acute GI-GVHD.