The prevalence of allergic diseases in children with short bowel syndrome

BACKGROUND Short bowel syndrome is the result of an extensive surgical resection that leaves the length of the small intestine at a critical value for the proper nutritional absorption. An increased risk of food allergy has been described in patients who suffer from this condition. OBJECTIVE To describe the prevalence of allergic diseases in a group of patients with short bowel syndrome. METHODS A descriptive, cross-sectional, and ambispective study was carried out; it included patients with short bowel syndrome who had attended the nephrology service of the National Institute of Pediatrics in a period of 18 months. Information about medical records, surgery history, diet history, and food tolerance was collected with prior authorization of parents or legal guardians. Likewise, there was questioning about history of atopy, and validated questionnaires for allergic diseases were applied in Spanish. The following tests were carried out: skin tests with allergen extracts, determination of four foods specific immunoglobulin E, patch test, and open oral food challenge. The protocol was authorized by the research ethics committee. RESULTS Fifteen patients with a median age of 44 months (range of 8-128 months) and with a male/female ratio of 2:1 were included. The most common causes of SBS were necrotizing enterocolitis and intestinal atresia. 27% of the patients had a family history of atopy and 40 % of the patients had a personal history that suggested an allergy to cow's milk in infancy. Allergic diseases were found in 40 %. CONCLUSIONS Allergic diseases seem to have high prevalence in patients with SBS. More studies in large populations are required in order to confirm this discovery.