Percorsi clinici
Un bambino di due anni che rifiuta il cibo e vomita
A 2 YEARS OLD BABY WITH RECURRENT VOMIT AND FOOD REFUSAL
ZEMIRA CANNIOTO, FEDERICO MARCHETTI, EGIDIO BARBI, ALESSANDRO VENTURA
Clinica Pediatrica, IRCCS Burlo Garofolo, Universit di Trieste
Maggio 2006 - pagg. 311 -314
Abstract
This case report summarizes the clinical features, pathogenesis and treatment of food aversion through the story of a 2 years old child with recurrent vomit and food refusal. This is a common pediatric syndrome which implies the differential diagnosis between several conditions such as organic problems, relational disorders and iatrogenic causes. The latter could be synthesized by a new acronym IGARIS (Iatrogenic Ghost Allergy and Reflux Infant Syndrome) which comprehends the possibility of causing/sustaining food aversion by means of repeated medical interventions especially imposing unjustified restricted diets and/or over-diagnosing gastro-esophageal reflux (GER). This is a relevant issue both in term of prevalence and need of a specific treatment, especially to avoid vicious circles of over-diagnosis and over-treatment. Our case demonstrates the importance of a behavioral approach in a case of food aversion due to relational and iatrogenic disorders in order to help the child and his family to re-discover the enjoyment of food.
Classificazione MeSH
Bibliografia
RGE e intolleranza alimentare
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Salvatore S, Vandenplas Y. Gastroesophageal reflux and cow milk allergy: is there a link? Pediatrics 2002;110(5):972-84.
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Kumar Y, Sarvananthan R. Gastro-oesophageal reflux in children. Clin Evid 2004;(11): 414-23.
Miceli Sopo S. Quanto conta lallergia alle proteine del latte vaccino nella genesi della malattia da reflusso gastroesofageo del bambino? Area Pediatrica 2005;4:35-41. Lavversione per il cibo
Rimmel N, De Meyer AM, Feenstra L, Veereman- Wauters G. The complexity of feeding problems in 700 infants and young children presenting to a tertiary care institution. J Pediatr Gastroenterol Nutr 2003;37(1):75-84.
Zangen T, Ciarla C, Zangen S, Di Lorenzo C, et al. Gastrointestinal motility and sensory abnormalities may contribute to food refusal in medically fragile toddlers. J Pediatr Gastroenterol Nutr 2003;37(3):287-93.
Field D, Garland M, Williams K. Correlates of specific childhood feeding problems. J Paediatr Child Health 2003;39(4):299-304.
Gerarduzzi T, Biasotto E, Faleschini E, Martelossi S. The complexity of feeding problems in 700 infants and young children presenting to a tertiary care institution (letter). J Pediatr Gastroenterol Nutr 2004;38(3):360-1.
Wright CM, Parkinson KN, Drewett RF. How does maternal and child feeding behavior relate to weight gain and failure to thrive? Data from a prospective birth cohort. Pediatrics 2006;117(4):1262-9.
Magazz G, Scoglio R. Gastrointestinal manifestations of cows milk allergy. Ann Allergy Asthma Immunol 2002;89(6 Suppl 1):65-8.
Salvatore S, Vandenplas Y. Gastroesophageal reflux and cow milk allergy: is there a link? Pediatrics 2002;110(5):972-84.
Marchetti F. Intolleranza alle proteine del latte vaccino e reflusso gastroesofageo: cosa c di vero? Medico e Bambino, pagine elettroniche, 2005 giugno, 8(6); http://www.medicoebambino. com/index.php?id=ppt0506_10 .html
Gold BD. Review article: epidemiology and management of gastro-oesophageal reflux in children. Aliment Pharmacol Ther 2004;19 (Suppl 1):22-7.
Kumar Y, Sarvananthan R. Gastro-oesophageal reflux in children. Clin Evid 2004;(11): 414-23.
Miceli Sopo S. Quanto conta lallergia alle proteine del latte vaccino nella genesi della malattia da reflusso gastroesofageo del bambino? Area Pediatrica 2005;4:35-41. Lavversione per il cibo
Rimmel N, De Meyer AM, Feenstra L, Veereman- Wauters G. The complexity of feeding problems in 700 infants and young children presenting to a tertiary care institution. J Pediatr Gastroenterol Nutr 2003;37(1):75-84.
Zangen T, Ciarla C, Zangen S, Di Lorenzo C, et al. Gastrointestinal motility and sensory abnormalities may contribute to food refusal in medically fragile toddlers. J Pediatr Gastroenterol Nutr 2003;37(3):287-93.
Field D, Garland M, Williams K. Correlates of specific childhood feeding problems. J Paediatr Child Health 2003;39(4):299-304.
Gerarduzzi T, Biasotto E, Faleschini E, Martelossi S. The complexity of feeding problems in 700 infants and young children presenting to a tertiary care institution (letter). J Pediatr Gastroenterol Nutr 2004;38(3):360-1.
Wright CM, Parkinson KN, Drewett RF. How does maternal and child feeding behavior relate to weight gain and failure to thrive? Data from a prospective birth cohort. Pediatrics 2006;117(4):1262-9.
Corrispondenza: marchetti@burlo.trieste.it