Iovitsa T. The Clinic, Instrumental Characteristics and Optimization of Correction of Transient Lactase Deficiency in Infants

The thesis is devoted to the study of clinical and paraclinical features of the course of transient lactase deficiency (TLD), to the improvement of diagnosis and optimization of the correction of transient lactase deficiency in infants who are breastfed. The results of clinical, laboratory, instrumental examination of 302 children with functional gastrointestinal disorders are presented, including 241 patients with TLD and 61 children with functional gastrointestinal disorders not associated with lactose malabsorption. To assess the state of lactose intolerance children were given a hydrogen respiratory test with a load of food lactose. According to the results of determining the features of the clinic, the acidity of stool, carbohydrates in the feces, the state of the intestinal microbiota, the level of excretion of hydrogen into the exhaled air, three degrees of severity of TLD in infants who were breastfed were determined. Based on the calculated diagnostic coefficients and the informative value of clinico-laboratory indicators for TLD in infants, a diagnostic table was compiled, allowing in 96% of cases to establish a preliminary diagnosis of lactase deficiency. The correction of TLD by optimizing the starting doses of the lactase enzyme in accordance with a certain severity of TLD was optimized, and the appointment of the lactase enzyme at the recommended starting doses made it possible to eliminate the clinical manifestations of TLD for 3 days in 100% of children with mild and moderate severity and 94,4% of patients with severe manifestations of TLD.