Assessment of the mental status of the mothers of children with the food protein-i̇nduced allergic proctocolitis, enteropathy and enterocolitis syndrome during the elimination diet, depending on the clinical manifestations of their children

Objective: The prevalence of food allergies is increasing day by day in our country as well as in the world. Diagnosis of food allergy negatively affects the lives of both children and their parents. The only known treatment is dietary elimination to breastfeeding mothers and their children. This process can take months depending on the clinical condition of the children. Parents of children with food allergies experience emotional stress and restrictions in their daily activities. In this study, we aimed to evaluate the depression and mood of the mothers of children diagnosed with food protein-induced proctocolitis (FPİAP), enteropathy (FPE) and enterocolitis (FPİES) before and under diet, and to determine the clinical status of their children and the changes in their mothers' mental status. Materials and Methods: Our study included 42 pediatric patients aged 1-12 months who were diagnosed with food protein-induced proctocolitis, enterocolitis and enteropathy in the Bezmialem Vakıf University Pediatric Gastroenterology Hepatology and Nutrition outpatient clinic and their mothers. Participants were asked about the feeding habits of their children, how long they fed only with breast milk, when they switched to formula and complementary food, the time of birth of the children, their birth weight, the history of hospitalization and antibiotic use, the age of the mother, the education level of the mother, and the number of children in the family was recorded.The patients were weighed at the time of admission and at the control under diet, their clinical findings (irritability, breast refusal, gas pains, vomiting, mucous stools, bloody stools, steatorrhea, inability to gain weight, constipation) were questioned, and CoMiSS scoring was made and recorded in the study form. We clinically divided the patients in the study into 3 groups as FPİAP, FPİES and FPE. We divided the mothers of the patients and their children into three groups according to their diet. One of these was mothers who fed their children only with breast milk, the second was those who fed both breast milk and formula, and the third group was non-breastfeeding mothers who fed only formula. The mothers were asked to fill out the Beck Depression Scale and Beck Anxiety Scale twice, at the time of the first diagnosis before the diet and when they came to the control after 2 months, while they were under diet. SPSS 27.0 program was used in the analysis of the data. The distribution of variables was measured with the Kolmogorov-Smirnov test. ANOVA (Tukey test), Kruskal-Wallis, Mann-Whitney u test was used in the analysis of quantitative independent data. Wilcoxon test was used in the analysis of dependent quantitative data. Chi-square test was used in the analysis of qualitative independent data, and Fischer test was used when the Chi-square test conditions were not met. Spearman correlation analysis was used in the correlation analysis. Results: The month of diagnosis of the patients and the mean age of the mothers did not differ significantly between the FPİAP, FPE and FPİES groups (p> 0.05). Gender distribution among FPİAP, FPE and FPİES groups; Birth weight, mode of delivery, time of delivery, duration of exclusive breastfeeding, family history of atopy did not differ significantly (p > 0.05). When the pre-diet and post-diet comparisons were made in all groups, the CoMiSS value decreased significantly (p <0.05) compared to the pre-diet. In the group of mothers who fed their children only with breast milk, the post-diet anxiety score did not change significantly (p >0.05) compared to the pre-diet. Anxiety score after diet increased significantly (p <0.05) in the group of mothers fed with breast milk and formula. The post-diet anxiety and depression scores of mothers who fed their babies only with formula decreased significantly (p <0.05) compared to the pre-diet, and the amount of decrease was significantly higher (p < 0.05) than those who breastfed exclusively and both breastfed and formula fed groups. With only breast milk, the depression score after the diet increased significantly (p <0.05) compared to the pre-diet. In the breast milk and formula fed group, post-diet depression score increased significantly (p <0.05) compared to pre-diet. Post-diet anxiety and depression scores were significantly higher (p <0.05) in the group on a multiple nutrient elimination diet than in the group on a milk elimination diet alone. A significant positive (p < 0.05) correlation was observed between CoMiSS score and anxiety and depression scores in the post-diet period. Conclusion: When mothers of children with food allergies are exposed to diet, their mental state may deteriorate. While clinical improvement is achieved with diet therapy in children, it is important to take a multidisciplinary approach to mothers who have to diet in this process and to support them spiritually if necessary. Key words: Food protein induced allergic proctocolitis, food protein induced allergic enteropathy, food protein induced enterocolitis, elimination diet.