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Nutricia 8th Paeds Symp

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  • 1. "Is there any place for peptide based feed in the managementof eosinophillic oesophagitis or is amino acid formula best?" Ruth Charles Paediatric Dietitian. May 11, 2012
  • 2. Eosinophilic esophagitis (EoE): updated consensus recommendations for children andadults. Liacouras CA, J Allergy Clin Immunol. 2011 Jul;128(1):3-20Treatment of EoE Dietary modification:Aimed at Exclusion/AAF leads to resolution of•symptomatic relief symptoms –•histological changes Long term sustainability.•endoscopic remission Cost factor.•Patient specific, no one absolute Few foods selective diet avoid milk, egg,treatment. wheat, soy, nut and fish.•MDT approach required. Symptomatic improvement is less with dietary restriction than with AAF Supports: American Partnership for Eosinophilic Disorders: apfed.org Campaign urging research for eosinaphilic disease: curedfoundation.org Ruth Charles Paediatric Dietitian. May 11, 2012
  • 3. "What is the evidence for use of pre and probiotics in Allergic disease?" Ruth Charles Paediatric Dietitian. May 11, 2012
  • 4. Pre and probiotic use in food allergy.Facts Hypothesis• Probiotic approach adds one or two Manipulation of the intestinal microbiota may species to a spectrum of hundreds of therefore offer an approach to the prevention species in the gut flora or treatment of allergic diseases• Prebiotic approach aims at fertilization of the intestinal ecosystem.• Allergic children have a different intestinal flora from healthy children with higher levels of Clostridia and Issues lower levels of Bifidobacteria• Probiotics and prebiotics, used alone or Study designs , together (synbiotics), can influence the Strains & species intestinal microbiota and modulate Regimens . immune responses in vitro and in vivo. Dose & timing Ruth Charles Paediatric Dietitian. May 11, 2012
  • 5. Evidence for pre and probiotic use.Prevention of food allergy Treatment of food allergyProbiotics during weaning reduce the incidence of Clinical improvement, especially in allergic rhinitiseczema. (West 2009) and IgE-sensitized atopic eczemaMay be effective in eczema prevention.Probiotics in infants for prevention of allergic disease Various effects of different probiotic strains in allergicand food hypersensitivity. (Oborn 2007). disorders: an update from laboratory and clinical data. (Ozdemir 2010)Reduction in clinical eczema in infants .insufficient evidence to recommend the addition of Probiotics are not effective for the treatment ofprobiotics to infant feeds for prevention of allergic atopic dermatitis.disease. Probiotic effects in the treatment of asthma and allergic rhinitis are conflicting.Prebiotics in infants for prevention of allergic diseaseand food hypersensitivity. (Osborn 2007) CochraneInsufficient evidence to determine the role of Cows milk allergy.prebiotic supplementation of infant formula forprevention of allergic disease Extensively hydrolysed casein formula supplemented with Lactobacillus rhamnosus GG maintains hypoallergenic status: randomised double-blind,Lactobacillus F19 during weaning could be an effective placebo-controlled crossover trial.tool in the prevention of early manifestation of (Muraro 2012)eczemaProbiotic effects on T-cell maturation in infants Probiotics and prebiotics in allergy prevention and treatment:during weaning. (West 2012) future prospects Expert Rev. Clin. Immunol. 8(1), 17–19 (2012) Ruth Charles Paediatric Dietitian. May 11, 2012
  • 6. Food allergy in Ireland. The future… Currently in draft: Diagnostic algorithms for primary and secondary care Food specific carepathways:, cow’s milk, egg, peanut, treenut. Ruth Charles Paediatric Dietitian. May 11, 2012