PubMed Health⌕ Search

Biomedical subjects

B B Fink

Publications and source records attributed to B B Fink.

6 recordsLinked to original sources
PubMed1981

Respiratory hydrogen secretion: a simple test of bowel adaptation in infants with short gut syndrome.

The prime goal in the management of infants with short gut syndrome is the smooth transition from total parenteral alimentation to total gastrointestinal alimentation. Such transition is dependent upon early feeding to actively promote the intestinal mucosal hyperplasia that is the key to eventual oral alimentation. A modular hyposmolar formula was previously reported to be successful in promoting the intestinal adaptation in several infants with short gut syndrome. Progression of the daily diet was dependent upon the day's clinical response, i.e., whether a change in volume or substrate composition resulted in increased stooling or diarrhea. Diarrhea occurs when the substrate load exceeds the absorptive capacity of the intestine and may be severe enough to require a return to parenteral alimentation until intestinal recovery is complete. Monitoring of daily breath H2 has provided an early warning mechanism to indicate carbohydrate overload in the adapting bowel before clinical signs of malabsorption occur. It provides an accurate daily measure of the bowel's ability to utilize the specific volume and caloric density it is being presented, thereby allowing diet advancement in a controlled fashion. The use of the breath H2 test in three infants with short gut syndrome has assisted in the transition to oral alimentation in 3 to 20 wk without the complications of severe diarrhea.

Adaptation, Physiological↗
PubMed1980

Lactose malabsorption by premature infants: magnitude and clinical significance.

Sequential studies of breath hydrogen excretion in response to lactose feeding were carried out in 22 premature infants during the first seven weeks of life. Seventy-five percent of infants excreted H2 in breath during the first two weeks, 100% by the end of the third week. The peak H2 concentration and the five-hour mean breath H2 excretions were significantly related to lactose intake per day, lactose intake per feeding and postnatal age, though only lactose intake per day remained significant when all three variables were included in multiple regression analysis. Preprandial breath H2 concentration was inversely related to the frequency of feeding. Using the five-hour mean H2 excretion, it was estimated that 66% or more of ingested lactose entered the colon and was fermented. Throughout the studies stool patterns and rates of weight gain of the infants were normal. Premature infants normally malabsorb substantial amounts of lactose. The elevation of breath H2 in these infants apparently represents a successful adaptation of the colonic microflora to this physiologic malabsorption and should not be cause to modify the diet of an infant who is clinically well.

Humans↗