Lactose-free milk formula usefulness supplemented added with pectin and s. Boulardii in children's with not complicated acute gastroenteritis (LFPS)

Background: Diarrheal diseases are one of the most important causes of morbidity and mortality in children under 5 years of age. In the first years of life, milk continues to be essential part of a child's diet. Providing a milk formula lactose free added whit pectin and probiotic, designed to improve its intestinal tolerability and to maintain an adequate nutritional intake, have an effect on enteral symptom duration. Objective: To evaluate LFPS effectiveness in children 1‐3 years of age with not complicated acute gastroenteritis. Materials and methods: All patients at admission underwent a complete medical history and examination, stool test and Rotatest. Patients were randomized into two groups: The first group (control) received an anti‐diarrhea diet and 45 mEq/Lt rehydration solution (RS) and the milk formula previously used. Group 2 received the same treatment plus LFPS (S. boulardii 51.5 mg/100 ml). Evaluations at start, third and fifth day were performed. Body weight, number of bowel movements, duration of diarrheic symptoms, duration of oral rehydration therapy, and anti‐diarrhea diet were assessed at beginning and end of the study. SPSS Statistics (v 17.0) was used for statistical analysis. X 2 or Fisher's exact test and Student's test were used. Significance value was 0.05. Results: 40 patients without dehydration were included, with a mean age of 18.74 months, there were no differences in demographic characteristics. The duration of diarrheic symptoms was 43.1 hours in group 1, and 31.00 in group 2 (p =0.0001, CI 7.788‐16.402). Bowel movements on third day in group 1 were 2.71, and 1.89 in group 2 (p =0.0.009, CI 2‐2.65), on fifth day in group 1 were 0.67, and 0.16 in group 2 (p =0.001 CI 0.2‐0.65). RS was administrated for 1.9 days in group 1, and 1.47 in group 2 (p =0.059, CI 0.177‐0.879). The days of using diet in group 1 were 2.48, and 1.95 in group 2 (p =0.003 CI 0.197‐1.861). Body weight of group 1 had an average of ‐66 g at the end of the study with regard to that at admission, and group 2 had an average of +179 g with respect to that at admission, without statistical significance (p=0.50). Discussion: Comparing the use of LFPS in two similar populations of children's shortened disease duration significantly. Bowel movement pattern significantly improved on third day when using LFPS, comparing to standard treatment. Need to modify diet was shorter with LFPS, but with no effect on replace fecal losses with oral rehydration therapy. Although there is no significant difference in patient body weight, LFPS use prevented not only loss of weight, but contributed to its increase. Evidence obtained in the study is limited by test group size, and would be more robust if test patient number is increased. Therefore, it is concluded that the use of LFPS demonstrated to be more effective than traditional management. Of note, shortening of symptom duration is similar to that observed with other drugs (Single probiotics, Racecadotril). Studies with a larger number of children comparing different therapeutic options are recommended.