ABSTRACT
Approximately 70% of the world's population is lactase deficient. This article reviews the evolutionary history of lactase deficiency, recent recommendations to establish screening, and clinical practice guidelines for increased diagnosis of this important, yet often misunderstood condition of malabsorption.
Subject(s)
Lactose Intolerance/nursing , Mass Screening/nursing , Nursing Diagnosis , Practice Guidelines as Topic , Diagnosis, Differential , Humans , Lactose Intolerance/epidemiology , Lactose Intolerance/physiopathology , Nurse Practitioners , Patient Education as Topic , Prevalence , Terminology as TopicABSTRACT
OBJECTIVE: To develop a clinic for patients who believe they have a food intolerance that could be administered by practice nurses with minimal experience of dietary change or food intolerance. METHODS: The clinic consisted of 1 week baseline, 2 weeks healthy eating plan (HE), 2 weeks wheat and dairy free plan (WD). Patients were discharged after the HE plan if their symptoms had improved, otherwise they continued onto the WD plan. Following training 4 nurses ran 4 clinics across the UK. RESULTS: 281 patients with perceived food intolerance were recruited. The most common symptoms were bowel symptoms, tiredness, stomach symptoms, and headaches. Of those who completed the programme (n=150), the majority were discharged after the HE plan as their symptoms had improved (n=106, 70.6%). A third also completed the WD plan (n=44, 29%). Symptoms, mood and quality of life improved significantly by the end of the intervention. WD showed added value as symptoms showed further improvement. CONCLUSION: There was a need for the clinic although not on a full time basis. Symptoms improved following both the HE and WD plans. PRACTICE IMPLICATIONS: A simple dietary based intervention may help relieve symptoms in those who believe they have a food intolerance.
Subject(s)
Food Hypersensitivity/nursing , Patient Education as Topic , Primary Health Care/organization & administration , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Lactose Intolerance/nursing , Male , Middle Aged , Program Development , Program Evaluation , Quality of Life , United Kingdom , Wheat Hypersensitivity/nursingABSTRACT
La alergia-intolerancia a la proteína de la leche de vaca (APLV-IPLV) es la alergia alimentaria más frecuente en la primera infancia en nuestro medio, relacionada con factores ambientales y genéticos. Suele aparecer en los primeros meses de vida, tras la introducción de la PLV y se manifiesta con síntomas dependientes del mecanismo involucrado (inmunológico o no). El diagnóstico se realiza a través de la historia y se completa con pruebas de laboratorio. El tratamiento consiste en la exclusión de la PLV de la dieta. Las fórmulas derivadas de la leche de vaca se sustituyen por una fórmula hidrolizada o de soja. El pronóstico es bueno: los pacientes responden a la dieta de exclusión y en la mayoría de ellos se logra la tolerancia a la PLV. El rol de la enfermera resulta fundamental en la educación a los padres y, posteriormente, del propio niño, para lograr una dieta completamente exenta de proteínas de leche de vaca (PLV)(AU)
An allergy or intolerance to cow's milk protein (APLV-IPLV) is the most frequent food allergy among early childhood in our environment, related to genetic and environmental factors. This allergy tends to appear during the first few months of life, after the introduction of cow's milk protein in a child's diet and it manifests itself with symptoms which depend on foreign matter being introduced (immunological or otherwise). A diagnosis is made by means of the patient's case history and is completed by laboratory tests. Treatment consists of excluding cow's milk protein from the child's diet. Formulas derived from cow's milk are substituted by a hydrolyzed formula or one based on soybean. The prognosis is good: patients respond to this diet which does not include cow's milk protein and the majority of patients succeed in forming tolerance for cow's milk protein. A nurse's role is fundamental in educating parents and later on the child in order to achieve following a diet which completely eliminates cow's milk protein (PLV)(AU)
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Milk Hypersensitivity/nursing , Nurse's Role , Lactose Intolerance/nursing , Food Hypersensitivity/nursing , Risk Factors , Patient Education as Topic , Genetic Predisposition to DiseaseSubject(s)
Lactose Intolerance/nursing , Milk Hypersensitivity/nursing , Nursing Diagnosis , Breast Feeding , Child Nutrition Sciences , Humans , Infant , Infant Food , Infant Nutritional Physiological Phenomena , Infant, Newborn , Lactose Intolerance/diagnosis , Milk Hypersensitivity/diagnosis , Parents/educationSubject(s)
Breast Feeding , Infant Welfare , Lactose Intolerance/nursing , Milk Hypersensitivity/nursing , Humans , Infant , Infant Food , Infant, NewbornABSTRACT
La eficacia de las dietas libres de lactosa en forma rutinaria en niños menores de tres años con enfermedad diarreica aguda, en comparación con dietas con lactosa, no ha sido demostrada en forma consistente y significativa a pesar de múltiples estudios realizados. Para determinar si esta diferencia existe, se diseñó un meta-análisis que nos permitió reunir cuantitativamente los resultados de 15 experimentos clínicos controlados, con un total de 1.364 pacientes, seleccionados por su adecuada calidad metodológica, que intentaban responder la hipótesis planteada. Los parámetros evaluados fueron: 1. Duración de la diarrea en días o enhoras medida como la diferencia (tiempo con lactosa-tiempo sin lactosa). 2. Falla terapéutica medida por el RRI (Odds radio: Con lactosa/Sin lactosa). y 3. La ganancia ponderal teniendo en cuenta variación en el peso post-tratamiento respecto al ingreso. El análisis indicó que no hay diferencias estadísticamente significativas en cuanto a la duración de la diarrea en días (0,03 días con IC 95 por ciento -0.4 a +0,3). Sin embargo, al anlizar los estudios que informaron la duración de la diarrea en horas, sugieren que la dieta con lactosa puede incrementar en algunas horas su duración (+12,8 horas con IC 95 por ciento +4,1 a +21,5). En cuanto al análisis por falla terapéutica, sugiere que en conjunto los niños que reciben lactosa tienen un riesgo aproximadamente 2 veces mayor que los que no la reciben (RRI 1,91 con IC 95 por ciento 1,28 a 2,86). Los resultados sugieren que el empleo rutinario de dietas sin lactosa en niños con enfermedad diarreica aguda (EDA) puede producir resultados diferentes según la variable empleada para medir la efectividad. La diferencia obtenida en duración por horas no tiene importancia clínica. La diferencia obtenida en cuanto a falla terapéutica está a favor de la utilización de fórmulas libres de lactosa.
Subject(s)
Humans , Child, Preschool , Child , Diarrhea, Infantile/classification , Diarrhea, Infantile/diagnosis , Diarrhea, Infantile/drug therapy , Diarrhea, Infantile/etiology , Diarrhea, Infantile/nursing , Lactose Intolerance/classification , Lactose Intolerance/diagnosis , Lactose Intolerance/etiology , Lactose Intolerance/nursingABSTRACT
Gestational diabetes is the most common complication of pregnancy. If maternal hyperglycemia is not well controlled, excess glucose is transmitted to the fetus, which can lead to fetal macrosomia and maternal and fetal complications. Dietary treatment for gestational diabetes varies among practitioners. A case review is presented of a 32-year-old white woman with gestational diabetes whose condition was complicated by her blood glucose intolerance to lactose in milk. By following a carefully monitored regimen using specific dietary manipulation to maintain normoglycemia, the woman was able to deliver a normal, healthy baby by spontaneous vaginal delivery.
