부산대학교 도서관

To study the effects of early home management of acute diarrhoea on intestinal permeability, 55 children aged 3-25 (mean 13) months with acute gastroenteritis (65 % rotavirus) were given 4 g lactulose (lacl) and 0.8 g mannitol (man) after oral rehydration. An aliquot of urine passed in the subsequent 5 h was preserved for sugar analysis by gas-liquid chromatography. The patients showed a significant increase in lacl/man excretion compared to 28 controls. This was due to decreased excretion of man whereas the differences in lacl were insignificant. The patients given uninterrupted feedings in addition to adequate fluid replacement prior to hospitalization (n = 21) had a normal lacl/man excretion, mean 0.03 with 95 % confidence interval (CI) 0.01-0.05 compared to those fasted with inadequate (n = 13) or adequate (n = 21) fluid replacement (mean 0.25, 95 % CI 0.15-0.44 and mean 0.12, 95 % CI 0.09-0.18, respectively); F = 19.58, p < 0.001. This was caused by increased excretion of lacl while the excretion of man remained unchanged. In 14/55 patients retested after 2 days realimentation in hospital, the lacl/man urinary recovery did not differ from the admission level, mean difference in excretion ratio was 0.01 with 95 % CI from -0.08 to 0.1. These results indicate that fasting maintains the increased intestinal permeability caused by the infection whereas early feeding may hasten the recovery from acute gastroenteritis. Therefore, the results suggest that early feeding at home is beneficial.