title: Stepwise diet management in pediatric gastrointestinal graft versus host disease.
abstract: Gastrointestinal tract is one of the major systems affected by graft-versus-host disease (GVHD). Injury to the gut during conditioning therapy before stem-cell transplantation (SCT) plays a pivotal role in the initiation of inflammatory stimuli. We reviewed medical records of the patients who underwent SCT between April 2010 and June 2013 in our center. A stepwise upgrade diet was given to the children with acute GI-GVHD (Gastrointestinal GVHD) including parenteral and enteral nutrition. A total of 105 patients underwent SCT and seven patients developed grade III-IV acute GI-GVHD. Total parenteral nutrition (TPN) was initiated to all patients after the diagnosis of GI-GVHD and minimal enteral nutrition (1-2 ml/kg/day standard pediatric enteral formula/special meat soup) was given to the patients. GI-GVHD improved in all patients with no change in body weight, and recovery to a normal diet took 10-30 days. Stepwise diet management of oral nutrition contributed to rapid improvement of grades III-IV acute GI-GVHD.
authors.affiliation: Pediatric Nutrition and Metabolism, Ankara Child Health and Diseases, Hematology-Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Nevra
authors.initials: N
authors.lastname: Koç
authors.affiliation: Pediatric Nutrition and Metabolism, Ankara Child Health and Diseases, Hematology-Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Gündüz
authors.affiliation: Pediatric Hematology, Department of Pediatrics, Ankara Child Health and Diseases, Hematology-Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: M Fatih
authors.initials: MF
authors.lastname: Azık
authors.affiliation: Pediatric Hematology, Department of Pediatrics, Ankara Child Health and Diseases, Hematology-Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Betül
authors.initials: B
authors.lastname: Tavil
authors.affiliation: Pediatric Hematology, Department of Pediatrics, Ankara Child Health and Diseases, Hematology-Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Dilek
authors.initials: D
authors.lastname: Gürlek-Gökçebay
authors.affiliation: Pediatric Nutrition and Metabolism, Ankara Child Health and Diseases, Hematology-Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Eda
authors.initials: E
authors.lastname: Özaydın
authors.affiliation: Pediatric Hematology, Department of Pediatrics, Ankara Child Health and Diseases, Hematology-Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Bahattin
authors.initials: B
authors.lastname: Tunç
authors.affiliation: Hematopoietic Stem Cell Transplantation Unit, Ministry of Health, Ankara Child Health and Diseases, Hematology-Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Duygu
authors.initials: D
authors.lastname: Uçkan
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004032:Diet; D005260:Female; D005767:Gastrointestinal Diseases / Q000178:diet therapy* / Q000209:etiology; D006086:Graft vs Host Disease / Q000178:diet therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D010288:Parenteral Nutrition / Q000379:methods*
keywords: children; diet management; gastrointestinal graft versus host disease; hematopoeietic stem cell transplantation