Modern therapy of food allergy in children builds on the etiological factors and features of its pathogenetic mechanisms. In this case, is a leading prichinnoznachimyh elimination of food allergens with dietary correction and medication with pharmacological agents that affect various parts of its pathogenesis. These include drugs that prevent release of biologically active substances from mast cells (preventive means); drugs, cope with the consequences pathophysiological phases of allergic reactions (antihistamines, antiserotoninovoe) means normalizing the status of the gastrointestinal tract, immunomodulatory drugs.
Diet therapy
Diet therapy as a way to treat food allergies in children, is used for a long time. Diet therapy requires an individual approach to the sick child, an adequate substitute eliminated products of equal nutritional value and caloric content, with good perenosimosimostyu and digestibility. Tactics use elimination diets depends on the survey period a sick child with food allergies. Initially, based on clinical symptoms and medical history information about the intolerance of certain foods, the child shall be appointed elimination diet, such as hypo-allergenic, and Low Lactose free, dairy-free, agliadinovye rations. Empirical elimination diet also provides for the exclusion of products that are highly allergenic potential (eggs, fish, mushrooms, coffee, cocoa, chocolate, honey, citrus, carrots, strawberries, raspberries, tomatoes, nuts, black and red currants, pineapple, melon, etc. ), extractives, and later on identified prichinnoznachimyh allergens.
Construction of elimination diet requires certain knowledge and skills. For example, children up to 6 months with dyspeptic symptoms (when the alleged lactase deficiency) initially recommended a mixture of lactose free or soy-based milk protein hydrolysates. Sick children older than 6 months may be partly to keep breast milk and / or the use of low-and lactose free formula milk, which are adapted or partially adapted, hydrolysates of casein or whey proteins of cow’s milk. With the ineffectiveness of this diet 6-7 days a child is transferred to dairy-free diet in order to confirm or reject milk allergy. As a substitute for cow’s milk-adapted, specialized formulas based on soy protein isolates that do not contain milk protein and lactose. Presented a mixture of soy in their chemical composition closer to breast milk, enriched with vitamins and minerals.
The effectiveness of soy mixtures was observed in 85% of children with 1-1,5 weeks after the complete translation into soya blend marked positive clinical dynamics: improved general condition, appetite, have disappeared or significantly decreased skin rashes and itching, normalized stool. In appointing the soy mixture must consider the possibility of allergic reactions to soy protein. In our studies, 22% of children have exacerbation of cutaneous and gastrointestinal manifestations of allergy in the soy mixture.
Contentious and unresolved issue to date is the duration of the dairy-free diet. In our studies, it was found that the duration of dairy-free diet depends on the degree of sensitization to cow’s milk protein and ranges from 1.5 to 3 years. Attenuation reactions to cow’s milk protein is largely dependent on the nature of the prior-feeding, the child’s age, concomitant lactase deficiency diseases of the digestive system. The criteria for the introduction of dairy products in the diet were stable remission of the disease and low titers of specific antibodies to cow’s milk protein.
In the absence of positive dynamics of a dairy-free diet was connected agliadinovaya diet with complete exclusion glyutensoderzhaschih products and dishes made from wheat, rye, barley and oats. For the full replacement of cereal TE Borovik [13] offers a gluten-free, dry concentrates of bread, pastries, desserts (mousses, drinks), cereal-type “instant”, made from rice, buckwheat, cornmeal, or a combination thereof.
Intolerance to cereal should avoid eating hot dogs, canned meat for breakfast, sausages, pies, sauces, processed cheese with cereal fillers, wheat flakes, wheat germ, bread from wheat flour, pancakes, waffles, pies, cakes, pasta, pasta and vegetables with thick flour sauces, casseroles, puddings, chocolate candies.
When milk and soy allergy designate products that are based on milk protein hydrolysates (“Nutramigen”, “Pregestemil”, “Alimentum”, “Pepti-Junior”, “Nieda”, etc). They casein and whey proteins rasshepleny to small peptides with weak anitigennymi properties. It is composed as medium chain triglyceride, vegetable oils, sugar, vitamins and mineral salts.
Positive dynamics of clinical symptoms is a criterion for assigning maintenance diet for a period of 1,5-2 years c possibility of transferring the child to a normal diet or a partial introduction of previously excluded products.
