Nutrition after treatment for congenital biliary atresia

Neonatal biliary atresia is a disease that causes cholestatic jaundice in young children, if not treated early, it can lead to bad complications such as cirrhosis, liver failure and death. The only treatment for congenital biliary atresia is surgery. Treatment after surgery with care and nutritional supplements is focused to avoid future complications for the child.

As mentioned, congenital biliary atresia has only surgical management. The choice of surgical method also depends on the anatomical abnormalities of the hepatobiliary system with the following methods:
Surgery of the common hepatic-jejunal duct for common bile duct atrophy or atrophy of the common hepatic duct Kasai surgery ( Entero-hepatic anastomosis) creates a bile duct from the liver with a part of the small intestine, this is the most common type of surgery because it is effective in cases of atrophy of the bile ducts in the hilar region, accounting for up to 88 % of endemic cases Liver transplant surgery is a method to help children with congenital biliary atresia avoid cirrhosis with a very high 10-year survival rate. In general, all types of surgery to resolve congenital biliary atresia will change the continuity and characteristics of the hepatobiliary system, especially the biliary tract, so the postoperative nutrition will be of great importance to the patient. with recovery as well as avoid complications later.

Before giving specific nutrition, it is necessary to know the changes in the child's digestive system before surgery and after surgery to find the cause of the problems in the child's development.

In children with biliary atresia, the intestines will not receive enough bile due to a decrease in secretion, thereby damaging the liver's metabolic and absorption functions, causing the liver to reduce absorption of fat-soluble vitamins such as A, D, and E. , K and micro iron, poor. For this reason, it is absolutely necessary to include micronutrients and vitamins in the child's diet.

Nutritional problems after surgery will be difficult for babies, the most common is slow weight gain, malabsorption and digestive disorders in children due to the following reasons:
This surgery with children Newborn is a big case, it takes a long time to fully recover. A child's stay in the hospital for too long makes them more susceptible to mixed infections, especially hospital infections. Children's poor absorption of food is due to stasis. preoperative bile and even recurrence

There are 2 stages that need to be paid attention to in the post-operative nutrition regimen for treating biliary atresia of children: the stage of children under 6 months and children in the age of weaning. The reason is that children with congenital biliary atresia are best advised to have surgery at 1 to 2 months to resolve the cholestasis as soon as possible. Therefore, the period from 2 to 6 months is the period after surgery, the child needs to recover with a suitable diet as follows:
Children in this period should only eat milk, should not be using nutritious weaning foods. Should choose milk products with hydrolyzed protein and MCT for children who still have jaundice because at this time the amount of bilirubin in the blood is still high, these products will be more easily absorbed by children. If stasis and bilirubin return to normal limits, liver function is stable, you can choose breast milk or formula, hydrolyzed protein milk At the age of starting weaning, it is necessary to pay attention to supplementing with energy and necessary nutrients for children to fully develop mentally and physically. Children's nutrition should be ensured as follows:
Variety of foods to give children a complete meal rich in nutrients and enough energy. Vegetables should choose dark green leafy vegetables because they will add more trace elements of zinc and iron for children. A week, children should be supplemented with 1-2 meals rich in vitamin A and Beta Caroten such as pumpkin, carrots, and tomatoes, but they should not be used too much, which can cause jaundice due to beta carotene stagnation. Children can eat many foods. Protid types of animal origin, seafood Restricted foods for children to eat after surgery for congenital biliary atresia include:
Red meats such as beef, buffalo, goat, ... contain many Amino acids make the young liver work harder Animal fat because it is easy to digest Organs such as heart, liver and kidney Animal food coloring, food containing preservatives and canned food, industry